Differential Diagnosis for Neutrophil Predominant Leukocytosis with Monocytes and Tree in Bud Nodularity on CT Chest
- Single Most Likely Diagnosis
- Infectious Bronchitis or Bronchiolitis: This condition is characterized by an inflammatory response to an infection in the bronchioles, which can lead to neutrophil predominant leukocytosis. The "tree in bud" pattern on CT chest is indicative of bronchiolar plugging, often seen in infectious bronchitis or bronchiolitis.
- Other Likely Diagnoses
- Chronic Bronchitis: Part of chronic obstructive pulmonary disease (COPD), chronic bronchitis can cause a similar inflammatory response and may present with a mix of neutrophils and monocytes. The "tree in bud" pattern can also be seen due to chronic bronchial inflammation.
- Cystic Fibrosis: This genetic disorder leads to chronic lung infections and inflammation, which can result in neutrophil predominant leukocytosis and the characteristic "tree in bud" nodularity due to bronchiectasis and bronchial plugging.
- Do Not Miss Diagnoses
- Tuberculosis: Although less common, tuberculosis (TB) can present with a variety of chest CT findings, including the "tree in bud" pattern, especially in the context of endobronchial spread. Missing TB could have significant consequences due to its infectious nature and the need for specific treatment.
- Fungal Infections: In immunocompromised patients, fungal infections like aspergillosis can cause similar radiographic findings and must be considered to avoid missing a potentially fatal diagnosis.
- Rare Diagnoses
- Diffuse Panbronchiolitis: A rare condition characterized by chronic inflammation of the bronchioles, which can lead to the "tree in bud" appearance on CT scans. It's more common in East Asian populations and can present with neutrophil predominant leukocytosis.
- Bronchiolitis Obliterans: A rare lung condition that can follow a respiratory infection, leading to fixed airway obstruction. It might present with similar radiographic findings, although it's less likely to cause significant leukocytosis.