What are possible differentials for this pattern?
diffuse pulmonary haemorrhage: Goodpasture's syndrome, Wegner's granulomatosis, systemic lupus erythematosus, Behçet's syndrome, bleeding diatheses, among others; infection (atypical, such as PCP, influenza), non-cardiogenic pulmonary oedema
Right IJ CVC tip projects over the SVC. There is diffuse patchy groundglass opacity within both lungs predominately within the upper lobes and apical lower lobes with relative sparing of the bases. Compared with the prior examination this has improved within the right lung but is more confluent within the left lung, with infiltrates seen both centrally and peripherally. No interlobular septal thickening or nodules. The airways are normal. Pleural spaces are clear.
No pericardial effusion. No thoracic lymphadenopathy. No suspicious osseous lesions.
Conclusion: Diffuse alveolar infiltrates predominately within the upper lobes and apical lower lobes appear more confluent on the left and improved on the right compared previous imaging. Given the patient's history, appearances are in keeping with pulmonary haemorrhage.