Flash information
- Background
- Ground-glass opacity
- Lines
- Septal and/or intralobular
- Pattern
- Paving-stone appearance
- Value
- Not pathognomonic
Definition
Crazy paving combines ground-glass opacity with a visible linear network in the same lung regions.
Examination or reading method
Assess ground-glass background and superimposed lines separately on thin lung-window sections.
Morphological description
Describe distribution, symmetry, lobular boundaries and extent; assess consolidation or effusion.
Causes and diagnostic direction
Alveolar filling and interstitial involvement may coexist; pathological correlation varies with the disease.
Differential diagnoses
Alveolar proteinosis, oedema, pneumocystis pneumonia, haemorrhage and inflammatory pneumonias are part of the differential.
Associated findings
Timing, immunosuppression and respiratory manifestations help prioritise possible causes.
Red flags
Acute dyspnoea and hypoxaemia warrant prompt assessment, regardless of the presumed cause of the pattern.
Pitfalls and limitations
This appearance is not specific to alveolar proteinosis and cannot identify an infectious organism.
Take-home message
Identify both components, then use context to distinguish acute and chronic causes.
Sources
- The crazy-paving pattern: a radiological-pathological correlation ↗
- Verma R, Abdoh M. Crazy paving pattern. Clinical Case Reports (2017) ↗
Documentary review: 2026-10-12
Media source & rights
- Author
- Rajanshu Verma and Mamoun Abdoh
- Original source
- Rajanshu Verma and Mamoun Abdoh, Crazy_paving_pattern_on_chest_CT_scan.jpg, CC BY 4.0, Wikimedia Commons; conversion WebP et réduction proportionnelle.
- Licence
- CC BY 4.0
- Changes
- Conversion WebP, redimensionnement proportionnel sans recadrage ni annotations ajoutées; EXIF retiré. Dérivé écran proportionnel ≤1280 px, WebP qualité76 ; vignette ≤320 px qualité72. Source acquise et dérivé initial conservés sans modification ; aucune retouche médicale, aucun recadrage.
- Dimensions
- 709 × 500 px
- Check
- 2026-10-11T20:53:02.602603+00:00