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Table 5 Diagnostic clues for COVID-19 mimicker

From: Imaging of COVID-19 simulators

Final diagnosis Diagnostic clues Number of cases
Clinical history Pleural/cardiac involvement Pulmonary parenchymal involvement Laboratory/biopsy
Bronchial asthma History of bronchial asthma   Emphysematous changes
Subpleural sparing
Bronchiactasis
Peribronchial thickening
Centrilobular nodules due to superadded infection
  3
Eosinophilic lung Churg-Strauss syndrome History of bronchial asthma, sinusitis Pleural effusion   Peripheral eosinophilia 1
Drug rash with eosinophilia and systemic symptoms (DRESS) syndrome Clinical history, skin rash Pleural effusion   Peripheral eosinophilia 1
Loffler syndrome    Fleeting opacities Peripheral blood eosinophilia and high IgE level
Elevated eosinophilic count on bronchoalveolar lavage
1
H1N1     PCR test revealed HINI virus 1
ARDS Clinical criteria   Bilateral basal dense consolidation on a background of diffuse GGO in the non-dependent regions with bronchial dilatation in GGO and crazy paving appearance   3
Hypersensitivity pneumonitis Clinical history of exposure to antigen (Bird Fancier’s Disease)
Reproduction of symptoms following exposure
  Poorly defined centrilobular nodules
Headcheese lung in subacute phase
Lymphocytosis on bronchoalveolar lavage 4
RB-ILD History of smoking
No fever
  Ground-glass opacities and centrilobular nodules Bronchoalveolar lavage (BAL) findings (the presence of smokers’ macrophages and the absence of lymphocytosis)
Proved by biopsy
2
Amiodarone lung History of drug intake   Peripheral patches
Pulmonary nodules and septal thickening
Fiberoptic bronchoscopy with BAL and transbronchial biopsy 1
SLE with diffuse alveolar hemorrhage History of SLE, hemoptysis.   Upper lobe predominance, confluent consolidation sparing costophrenic angles and the lung periphery.   1
Trauma History of recent trauma Pneumothorax    5
Atypical bacterial infection Mycoplasma bronchopneumonia   Pleural effusion Peribronchial thickening, confined to lobes   1
Staph-penumonia    GGO peribronchial thickening and pneumatocele   1
Other bacterial pneumonia    Unilateral lung affection
Tree in bud
Bronchiectasis
  6
Alveolar sarcoid History of sarcoid
No fever
  Upper lobe affection, peribronchial thickening, mediastinal lymph nodes   1
Acute Interstitial Pneumonia Acute symptoms like ARDS   Bilateral asymmetric confluent GGO with consolidative patches more in the lower lobes Proved by transbronchial biopsy 1
Cryptogenic organizing pneumonia   Pleural effusion Atoll sign
Subpleural sparing
Confirmed by histopathological correlation 2
Pulmonary alveolar proteinosis    Asymmetric lung involvement with crazy paving appearance Confirmed by bronchoalveolar lavage 1
Metastatic Calcifications with renal failure History of renal failure   High-density centrilobular ground glass nodules with superadded infection   1
Cardiogenic pulmonary edema Clinical history Enlarged cardiac size +/− pericardial effusion, dilated pulmonary trunk, bilateral pleural effusion, Thickened interlobular septal, peri-lymphatic, and peribronchovascular thickening
Perihilar distribution of ground glass opacities (bat wing)
  3