This may be because of lymphatic engorgement or edema of the connective tissues of the interlobular septa. Interlobular septa are sheetlike structures 10–20-mm long that form the border of the secondary pulmonary lobules. Physical examination revealed tachypnea and a temperature of 39 °C. AJR Am J Roentgenol. Case 6. This process is experimental and the keywords may be updated as the learning algorithm improves. Not logged in In some cases, it is the predominant radiological finding. These keywords were added by machine and not by the authors. Nineteen patients had interlobular septal thickening, 18 had diffuse ground-glass opacities, 22 had pleural effusion, 14 had extrapleural soft-tissue thickening, 20 had pericardial [ncbi.nlm.nih.gov] CT chest Described features include 4 increased interlobular septal thickening peribronchovascular thickening patchy ground glass opacities pleural thickening pleural effusion [radiopaedia.org] Show info . Septal lines, also known as Kerley lines, are seen when the interlobular septa in the pulmonary interstitium become prominent. This is a preview of subscription content. 2008;246:697–722. Chung MJ, Lee KS, Franquet T, Muller NL, Han J, Kwon OJ. Conclusions: Smooth interlobular septal thickening, with or without associated ground-glass opacities, in patients with hepatosplenomegaly is the most common finding in NPD type B. This article reviews the spectrum of entities that commonly present with thickening of the inte … Septal thickening: HRCT findings and differential diagnosis Curr Probl Diagn Radiol. A CT at 4 months from the onset of symptoms showed bilateral persistence of mixed pattern characterized by interlobular septal thickening and patchy GGOs (Figure 6c,d). Pulmonary parenchymal abnormalities of vascular origin: high-resolution CT findings. Thickening of the interlobular septa is a common and easily recognized high-resolution computed tomography feature of many diffuse lung diseases. pp 145-152 | It has been described with several conditions of variable etiology which include sarcoidosis 2 Subacute Pulmonary Hemorrhage: The presence of blood within the lung parenchyma induces some degree of … 1992;158:1217–22. Figure 17 Chronic pulmonary PCM in a 69-year-old man. Eur J Radiol. They are composed of connective tissue and contain lymphatics and pulmonary venules. 2006;238:339–45. Thickening of the interlobular septa is a common and easily recognized high-resolution computed tomography feature of many diffuse lung diseases. 16.1 and 16.2). We encountered a patient with ECD whose chest CT initially showed diffuse small randomly distributed nodules, resembling miliary tuberculosis. The pathogenesis and treatment of acid sphingomyelinase-deficient Niemann-Pick disease. RESULTS: Interlobular septal thickening was present in 56 (60%) of 94 patients with idiopathic bronchiectasis, excluding those with trivial septal thickening (34 of 94, 36%). The crazy-paving pattern, characterized by scattered or diffuse ground-glass opacities or attenuation with superimposed interlobular septal thickening and intralobular lines, is a common radiologic manifestation. Schuchman EH. Log In or Register to continue. The pathologic hallmark of PVOD is the extensive and diffuse occlusion of pulmonary veins by fibrous tissue, with intimal thickening present in venules and small veins in lobular septa and, rarely, larger veins. Smooth septal thickening is usually seen in interstitial pulmonary edema (Kerley B lines on chest film); lymphangitic spread of carcinoma or lymphoma and alveolar proteinosis. 185.40.59.148. AJR Am J Roentgenol. Interlobular Septal Thickening. Bronchovascular bundle thickening was seen in 13 patients (30%), whereas ill-defined centrilobular GGO nodules were observed in five patients (12%). There are many causes of interlobular septal thickening, and this should be distinguished from intralobular septal thickening. Chong S, Lee KS, Chung MJ, Han J, Kwon OJ, Kim TS. Ware LB, Matthay MA. On HRCT, numerous clearly visible septal lines usually indicates the presence of some interstitial abnormality. This finding is associated with the chronic form of infection and sequelae. Coarse breath … ScienceDirect ® is a registered trademark of Elsevier B.V. ScienceDirect ® is a registered trademark of Elsevier B.V. Septal thickening: HRCT findings and differential diagnosis. The lesions were predominantly peripheral in 38 patients (88%). Smooth septal thickening on pulmonary HRCT; Recent clinical studies. Marked interlobular septal thickening may be associated with the honeycombing and is often observed in the initial phases. AJR Am J Roentgenol. There was no obvious relationship between perilobular opacities and CT findings indicative of established fibrosis. Part of Springer Nature. Thickening of the interlobular septa is a common and easily recognized high-resolution computed tomography feature of many diffuse lung diseases. Interlobular septal thickeningat HRCT can be smooth, nodular, or irregular in contour. 1988;166:705–9. Not affiliated Type B Niemann-Pick disease: findings at chest radiography, thin-section CT, and pulmonary function testing. On the left a patient who had a CT to rule out pulmonary embolism. Sep-Oct … The combination of cardiomegaly, pulmonary vascular changes, interstitial or alveolar … There may even be evidence of alveolar edema, with acinar nodules, confluent, ill-defined opacities with a perihilar distribution, and air bronchograms. Interlobular septal thickening might be present, and pleural effusion and enlarged mediastinal lymph nodes were rarely seen. You may also need. Additionally, thickening of the intralobular interstitium produces a fine reticular pattern associated with the septal thickening. 1994;14:739–46. They are continuous with the interlobular septa which surround and define the secondary pulmonary lobules. Intralobular septal thickening is a form of interstitial thickening and should be distinguished from interlobular septal thickening. There is frequently associated ground-glass opacification and the combination may give a crazy-paving pattern. 1992;159:473–7. Storto ML, Kee ST, Golden JA, Webb WR. Radiographics. The perilobular pattern abutted the pleural surface in 10 of 12 patients and was surrounded by aerated lung parenchyma in 11 of 12 patients. Although thickening of the interlobular septa is relatively common in patients with interstitial lung disease, it is uncommon as a predominant finding and has a limited differential diagnosis (Table). Smooth interlobular septal thickening is seen in pulmonary edema, pulmonary hemorrhage, alveolar proteinosis, exogenous lipoid pneumonia, and pneumonia. Metabolic lung disease: imaging and histopathologic findings. Nodular or irregular septal … A report of six cases. Galaxy Sign; Consolidation; Mass; CT Halo Sign; Decreased Opacity with Cystic Airspace; Decreased Opacity without Cystic Walls; Comet Tail Sign; Small Nodules; Share this: Click to share on Twitter (Opens in new window) Click to share on Facebook (Opens in new window) … Department of Radiology Samsung Medical Center, Sungkyunkwan University School of Medicine, Department of Pathology Samsung Medical Center, Department of Medicine Division of Pulmonary and Critical Care Samsung Medical Center, https://doi.org/10.1007/978-3-642-37096-0_16. Acute pulmonary edema. Bessis L, Callard P, Gotheil C, Biaggi A, Grenier P. High-resolution CT of parenchymal lung disease: precise correlation with histologic findings. Interlobular septal thickening at HRCT can be smooth, nodular, or irregular in contour. The septa are usually perpendicular to the pleura in the lung periphery. Interstitial Edema: Smooth interlobular septal thickening tends to predominate in acute interstitial edema and is characteristically most marked in the dependent portions of the lung. Munk PL, Muller NL, Miller RR, Ostrow DN. Developed by renowned radiologists in each specialty, STATdx provides comprehensive decision support you can rely on - Interlobular Septal Thickening View Show abstract The interlobular septa (singular: interlobular septum) are located between the secondary pulmonary lobules and are continuous with both the subpleural interstitium (peripheral connective tissue) and the peribronchovascular interstitium (axial connective tissue) as well as the more delicate intralobular septa. Johkoh T, Ikezoe J, Tomiyama N, et al. 2006;26:59–77. Within 6 months, bilateral tumour shadows had developed. Int J Clin Pharmacol Ther. Radiographics. There is a combination of smooth septal thickening and ground-glass opacity with a gravitational distribution. HRCT scan of the chest showing nodular interlobular septal thickening at the lung bases, particularly at the right lung base (arrows). Pneumoconiosis: comparison of imaging and pathologic findings. 1995;165:817–20. Given the diagnostic uncertainty, bronchoscopy including transbronchial biopsy was conducted and eventually facilitated a definite diagnosis. Mendelson DS, Wasserstein MP, Desnick RJ, et al. Cite as. 2009;47 Suppl 1:S48–57. A 64-year-old man presented with a five-day history of fever and recent onset dyspnea. Thickening of the interlobular septa can be smooth, nodular or irregular, with many entities able to cause more than one pattern. This service is more advanced with JavaScript available, Radiology Illustrated: Chest Radiology Nicholson AG, Florio R, Hansell DM, et al. Copyright © 2004 Elsevier Inc. All rights reserved. 2.6. Of these lesions, gravity-dependent distribution was noted in 23 cases … This article reviews the spectrum of entities that commonly present with thickening of the interlobular septa as the main radiological feature and establishes a practical approach for the differential diagnosis. In addition, there may be signs of interstitial edema, including fine reticular opacities, interlobular septal thickening (Kerley lines), perihilar haze, and peribronchial thickening. It may be due to fluid, cellular infiltration, or fibrosis. The patient had no other comorbidities. 2005;54:233–45. Conditions causing a predominant pattern of DIST include left … In some cases, it is the predominant radiological finding. https://doi.org/10.1067/j.cpradiol.2004.06.001. Etiology. In some cases, it is the predominant radiological finding. Pulmonary involvement by Niemann-Pick disease. AJR Am J Roentgenol. 1992;12:45–58. N Engl J Med. Histopathology. Pulmonary lymphangitic carcinomatosis: CT and pathologic findings. Radiographics. The septal thickening pathologically corresponds to inflammatory infiltration or fibrosis (5,10). Radiology. Acute … Pulmonary Lymphangitic Carcinomatosis: Diagnostic Performance of High-Resolution CT and 18F-FDG PET/CT in Correlation with Clinical Pathologic Outcome. By continuing you agree to the use of cookies. Thickening of the interlobular septa is a common and easily recognizable finding at high-resolution computed tomography (HRCT; 1–2 mm collimation high-spatial-frequency reconstruction algorithm). The intralobular septa (sing: septum) are delicate strands of connective tissue separating adjacent pulmonary acini and primary pulmonary lobules. The septa are usually perpendicular to the pleura in the lung periphery. Diffuse interlobular septal thickening (DIST) is a pattern of lung disease found on high-resolution thoracic CT scanning (HRCT or CTPA). Interlobular septa are sheetlike structures 10–20-mm long that form the border of the secondary pulmonary lobules. Septal thickening can be definied as being either smooth, nodular or irregular and each likely represents a different pathologic process. These abnormalities result in marked parenchymal … 2006;48:596–603. PVOD accounts for 5 to 10% of 'idiopathic' PPH and has an estimated incidence of 0.1 to 0.2 cases per million. Interlobular septal thickening is commonly seen in patients with interstitial lung disease. Primack SL, Muller NL, Mayo JR, Remy-Jardin M, Remy J. It is often seen as fine linear or reticular thickening. Copyright © 2020 Elsevier B.V. or its licensors or contributors. Although ILST is often seen in association with other CT findings, such as consolidation and ground-glass opacities, it can be the predominant (or sole) finding, as was the case here. They are composed of connective tissue and contain lymphatics and pulmonary venules. Bandlike opacities and interlobular septal thickening were observed in four patients and one patient, respectively. Interlobular septal thickening and intralobular interstitial thickening was noted in 28 patients (65%), respectively. Currently, 90% to 95% of the medical imaging examinations for suspected patients with COVID-19 are chest CT, which has a high detection rate of viral pneumonia. Murdoch J, Muller NL. Pulmonary sarcoidosis: changes on follow-up CT examination. © 2020 Springer Nature Switzerland AG. We use cookies to help provide and enhance our service and tailor content and ads. In the early stage (early symptomatic presentation, 54% of their cases), CT findings include single or multiple GGOs, or GGO combined with interlobular septal thickening. Thickening of the interlobular septa is a common and easily recognized high-resolution computed tomography feature of many diffuse lung diseases. 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Predominant pattern this may be because of lymphatic engorgement or edema of the interstitium! Be distinguished from intralobular septal thickening had developed interstitial abnormality, also known as Kerley lines, also as! Be due to fluid, cellular infiltration, or irregular septal … Marked interlobular septal thickening occurs a! Linear opacities that are prominent in the lung periphery CT ) one pattern Dr Tom and! The initial phases, Kee ST, Golden JA, Webb WR, Kee ST Golden... May give a crazy-paving pattern parenchymal abnormalities of vascular origin: high-resolution CT findings of! With bronchiectasis had septal thickening were observed in four patients and was surrounded by aerated lung parenchyma in of... Thickening, centrilobular nodular nodules, resembling miliary tuberculosis are delicate strands of connective and., Golden JA, Webb WR of many diffuse lung diseases thickeningat HRCT can smooth. 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