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1. Universidade Federal de Alagoas (UFAL), Maceió, AL, Brazil. 2. Clínica de Medicina Nuclear e Radiologia de Maceió (MedRadius), Maceió, AL, Brazil. Mailing address: Dra. Christiana Maia Nobre Rocha de Miranda. Clínica de Medicina Nuclear e Radiologia de Maceió (MedRadius). Rua Hugo Corrêa Paes, 104, Farol. Maceió, AL, Brazil, 57050-730. E-mail: maia.christiana@ gmail.com. interlobular and intralobular septa, patients with GD can present with alveolar opacities, capillary plugging by Gaucher cells, and interstitial opacities, with a predominance of lymphatic distribution, as well as respiratory infections. Other alterations described include pulmonary fibrosis, a miliary pattern and involvement of the hilar or mediastinal lymph nodes, as well as a reduction in lung volume as a consequence of hepatosplenomegaly. Radiographic examinations can reveal an interstitial pattern and can show any changes in bone structures. The diffuse pulmonary involvement seen in patients with GD indicates that it is a systemic disease. MDCT is an important tool for the initial evaluation and follow-up of these patients, and lung biopsy can be dispensed with when the tomography reveals interstitial opacities in an appropriate clinical and epidemiological context. When there is no clinical suspicion of GD, a tomographic finding of the crazy-paving pattern makes the radiologic diagnosis difficult. In such cases, the main differential diagnoses are alveolar proteinosis, pulmonary hemorrhage, pulmonary vasculitis, diffuse alveolar damage (acute respiratory distress syndrome), pulmonary edema, bronchioloalveolar carcinoma, Niemann-Pick disease, and radiation pneumonitis, as well as Pneumocystis, viral, lipoid, mycobacterial, interstitial, and eosinophilic pneumonia.

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