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). On HRCT, numerous clearly visible septal lines usually indicates the presence of some interstitial abnormality. AJR Am J Roentgenol. Although interlobular septal thickening occurs in a significant number of cases, it rarely represents the predominant pattern . Bandlike opacities and interlobular septal thickening were observed in four patients and one patient, respectively. Cite as. There is a combination of smooth septal thickening and ground-glass opacity with a gravitational distribution. https://doi.org/10.1067/j.cpradiol.2004.06.001. Nicholson AG, Florio R, Hansell DM, et al. Copyright © 2020 Elsevier B.V. or its licensors or contributors. Pulmonary parenchymal abnormalities of vascular origin: high-resolution CT findings. The septal thickening pathologically corresponds to inflammatory infiltration or fibrosis (5,10). It represents pathology in the periphery of the pulmonary lobules (ie, the interlobular septa). Often considered to have a limited differential diagnosis—pulmonary alveolar proteinosis, lipoid pneumonia, bronchioloalveolar cell malignancy—this pattern is now recognized as a CT manifestation of many diverse entities. Schuchman EH. Interlobular septal thickening at HRCT can be smooth, nodular, or irregular in contour. 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 . Radiology. Clinical practice. pp 145-152 | During the consolidation stage (second week of symptomatic presentation), … 1992;12:45–58. Subacute Pulmonary Hemorrhage: The presence of blood within the lung parenchyma induces some degree of … 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). Pulmonary sarcoidosis: changes on follow-up CT examination. 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. Nodular or irregular septal … AJR Am J Roentgenol. This process is experimental and the keywords may be updated as the learning algorithm improves. There was no obvious relationship between perilobular opacities and CT findings indicative of established fibrosis. 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). N Engl J Med. This service is more advanced with JavaScript available, Radiology Illustrated: Chest Radiology Interlobular Septal Thickening Only gold members can continue reading. Interlobular septal thickening Dr Tom Foster and Dr Vinod G Maller et al. Smooth septal thickening on pulmonary HRCT; Recent clinical studies. This is a preview of subscription content. Storto ML, Kee ST, Golden JA, Webb WR. They are composed of connective tissue and contain lymphatics and pulmonary venules. These keywords were added by machine and not by the authors. Septal lines, also known as Kerley lines, are seen when the interlobular septa in the pulmonary interstitium become prominent. Interlobular Septal Thickening. The septa present as irregular linear opacities that are prominent in the subpleural regions. 2006;238:339–45. Additionally, thickening of the intralobular interstitium produces a fine reticular pattern associated with the septal thickening. 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. Hansell DM, Bankier AA, MacMahon H, McLoud TC, Muller NL, Remy J. Fleischner Society: glossary of terms for thoracic imaging. Thickening of the interlobular septa is a common and easily recognized high-resolution computed tomography feature of many diffuse lung diseases. They usually occur when pulmonary capillary wedge pressure reaches 20-25 mmHg. 2006;26:59–77. The septa are usually perpendicular to the pleura in the lung periphery. 1985;145:505–10. Ware LB, Matthay MA. This area is comprised of the pulmonary veins, capillaries and their associated interstitium. Pulmonary Lymphangitic Carcinomatosis: Diagnostic Performance of High-Resolution CT and ¹⁸F-FDG PET/CT in Correlation with Clinical Pathologic Outcome. Copyright © 2004 Elsevier Inc. All rights reserved. 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. 2005;353:2788–96. HRCT scan of the chest showing nodular interlobular septal thickening at the lung bases, particularly at the right lung base (arrows). 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) … 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%). Etiology. Eur J Radiol. Case 6. Radiographics. It has been described with several conditions of variable etiology which include sarcoidosis 2 View Show abstract Thickening of the interlobular septa is a common and easily recognized high-resolution computed tomography feature of many diffuse lung diseases. Pulmonary lymphangitic carcinomatosis: CT and pathologic findings. Not logged in Jreige M, Dunet V, Letovanec I, Prior JO, Meuli RA, Beigelman-Aubry C, Schaefer N J Nucl Med 2020 … Log In or Register to continue. Munk PL, Muller NL, Miller RR, Ostrow DN. In some cases, it is the predominant radiological finding. Bronchovascular bundle thickening was seen in 13 patients (30%), whereas ill-defined centrilobular GGO nodules were observed in five patients (12%). This may be because of lymphatic engorgement or edema of the connective tissues of the interlobular septa. Developed by renowned radiologists in each specialty, STATdx provides comprehensive decision support you can rely on - Interlobular Septal Thickening You may also need. 1988;166:705–9. In some cases, it is the predominant radiological finding. Interlobular septal thickening is commonly seen in patients with interstitial lung disease. Chest CT demonstrated extensive upper lobe predominant subpleural consolidation with air bronchograms and extensive ground glass opacities with intralobular septal thickening (B–D). At a lobar level, 69% (514 of 748) of lobes with bronchiectasis had septal thickening. CT in the diagnosis of interstitial lung disease. 1992;159:473–7. AJR Am J Roentgenol. Figure 17 Chronic pulmonary PCM in a 69-year-old man. Marked interlobular septal thickening may be associated with the honeycombing and is often observed in the initial phases. Over 10 million scientific documents at your fingertips. Smooth interlobular septal thickening is seen in pulmonary edema, pulmonary hemorrhage, alveolar proteinosis, exogenous lipoid pneumonia, and pneumonia. 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. Interlobular septa are sheetlike structures 10–20-mm long that form the border of the secondary pulmonary lobules. Intralobular septal thickening is a form of interstitial thickening and should be distinguished from interlobular septal thickening. Histopathology. There may even be evidence of alveolar edema, with acinar nodules, confluent, ill-defined opacities with a perihilar distribution, and air bronchograms. Radiographics. Mendelson DS, Wasserstein MP, Desnick RJ, et al. Int J Clin Pharmacol Ther. In the rapid progression stage (days 3–7 of symptomatic presentation), CT findings include large, light consolidative opacities and air bronchograms. We encountered a patient with ECD whose chest CT initially showed diffuse small randomly distributed nodules, resembling miliary tuberculosis. 2005;54:233–45. 2006;48:596–603. The intralobular septa (sing: septum) are delicate strands of connective tissue separating adjacent pulmonary acini and primary pulmonary lobules. Metabolic lung disease: imaging and histopathologic findings. Hydrostatic pulmonary edema: high-resolution CT findings. On CT scans, diseases affecting one of the components of the septa are responsible for thickening and thus cause the septa visible [1] (Figs. Acute pulmonary edema. Diffuse interlobular septal thickening (DIST) is a pattern of lung disease found on high-resolution thoracic CT scanning (HRCT or CTPA). They are continuous with the interlobular septa which surround and define the secondary pulmonary lobules. Given the diagnostic uncertainty, bronchoscopy including transbronchial biopsy was conducted and eventually facilitated a definite diagnosis. Of these lesions, gravity-dependent distribution was noted in 23 cases … CT findings in lymphangitic carcinomatosis of the lung: correlation with histologic findings and pulmonary function tests. The perilobular pattern abutted the pleural surface in 10 of 12 patients and was surrounded by aerated lung parenchyma in 11 of 12 patients. 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. Septal thickening and ground-glass opacity with a gravitational distribution in a patient with cardiogenic pulmonary edema. Crazy paving in ILD is a CT feature of interstitial lung disease and is characterised by diffuse ground glass caused by a combination of interlobular septal and intralobular septal thickening resulting well demarcated patchy densities in the lungs. © 2020 Springer Nature Switzerland AG. 16.1 and 16.2). In some cases, it is the predominant radiological finding. These abnormalities result in marked parenchymal … Acute … Type B Niemann-Pick disease: findings at chest radiography, thin-section CT, and pulmonary function testing. 2008;246:697–722. Coarse breath … Radiology. Chung MJ, Lee KS, Franquet T, Muller NL, Han J, Kwon OJ. Conditions causing a predominant pattern of DIST include left … Radiology. 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). Johkoh T, Ikezoe J, Tomiyama N, et al. Thickening of the interlobular septa can be smooth, nodular or irregular, with many entities able to cause more than one pattern. 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. The septa are usually perpendicular to the pleura in the lung periphery. Interlobular septal thickeningat HRCT can be smooth, nodular, or irregular in contour. Bergin CJ, Muller NL. 2.6. Sep-Oct … AJR Am J Roentgenol. This finding is associated with the chronic form of infection and sequelae. Pneumoconiosis: comparison of imaging and pathologic findings. There is frequently associated ground-glass opacification and the combination may give a crazy-paving pattern. It may be due to fluid, Interlobular septal thickening might be present, and pleural effusion and enlarged mediastinal lymph nodes were rarely seen. The combination of cardiomegaly, pulmonary vascular changes, interstitial or alveolar … In some cases, it is the predominant radiological finding. Bessis L, Callard P, Gotheil C, Biaggi A, Grenier P. High-resolution CT of parenchymal lung disease: precise correlation with histologic findings. A 64-year-old man presented with a five-day history of fever and recent onset dyspnea. PVOD accounts for 5 to 10% of 'idiopathic' PPH and has an estimated incidence of 0.1 to 0.2 cases per million. The patient had no other comorbidities. Physical examination revealed tachypnea and a temperature of 39 °C. On the left a patient who had a CT to rule out pulmonary embolism. 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. 1994;14:739–46. 2009;47 Suppl 1:S48–57. Radiographics. Part of Springer Nature. It may be due to fluid, cellular infiltration, or fibrosis. 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. Interlobular septal thickening and intralobular interstitial thickening was noted in 28 patients (65%), respectively. In addition, there may be signs of interstitial edema, including fine reticular opacities, interlobular septal thickening (Kerley lines), perihilar haze, and peribronchial thickening. Thickening of the interlobular septa is a common and easily recognized high-resolution computed tomography feature of many diffuse lung diseases. Interlobular septa are sheetlike structures 10–20-mm long that form the border of the secondary pulmonary lobules. The lesions were predominantly peripheral in 38 patients (88%). They are composed of connective tissue and contain lymphatics and pulmonary venules. 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. There are many causes of interlobular septal thickening, and this should be distinguished from intralobular septal thickening. 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. Septal thickening can be definied as being either smooth, nodular or irregular and each likely represents a different pathologic process. Thickening of the interlobular septa is a common and easily recognized high-resolution computed tomography feature of many diffuse lung diseases. A report of six cases. By continuing you agree to the use of cookies. 1992;158:1217–22. Chong S, Lee KS, Chung MJ, Han J, Kwon OJ, Kim TS. Primack SL, Muller NL, Mayo JR, Remy-Jardin M, Remy J. 185.40.59.148. 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. Interlobular septal thickening on pulmonary HRCT. 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. Within 6 months, bilateral tumour shadows had developed. We use cookies to help provide and enhance our service and tailor content and ads. 1995;165:817–20. Not affiliated It is often seen as fine linear or reticular thickening. Pulmonary involvement by Niemann-Pick disease. High-resolution CT scan at the … 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. The pathogenesis and treatment of acid sphingomyelinase-deficient Niemann-Pick disease. Interlobular septal thickening, centrilobular nodular nodules, and ground glass opacities are frequently observed on chest computed tomography (CT).