interlobular septal thickening
Pulmonary
involvement in Kaposi sarcoma: correlation between imaging and pathology. A to D. High-resolution CT scans (A and B) of two patients with pulmonary KS that demonstrate marked peribronchovascular and interlobular septal thickening and the presence of small parenchimal nodules. Photomicrographs of histologic specimen show tumor cells infiltrating the periarteriolar connective tissue (C), and a neoplastic parenchymal nodule with indistinct borders (D) (HE, ×40).
Pulmonary
involvement in Kaposi sarcoma: correlation between imaging and pathology. A to D. High-resolution CT scans at the level of the upper lobe (A) and the lower lobe (B), of two patients with pulmonary KS, show extensive interlobular septal and peribronchovascular thickening. Photomicrographs of histologic specimens (C and D) show thickening of interlobular septa due to edema and tumor cells infiltration (HE, ×40).
Pulmonary
involvement in Kaposi sarcoma: correlation between imaging and pathology. A and B. High-resolution CT scan (A) shows areas of ground-glass attenuation and interlobular septal thickening in the upper lobes. A crazy-paving pattern is observed in the right upper lobe. Photomicrograph of histologic section (B) demonstrates infiltration of the interlobular septa due to edema and neoplastic cells and also edema filling the alveolar airspace (HE, ×40).
Lymphangitic
carcinomatosis • Lymphangitic carcinomatosis - Ganzer Fall bei Radiopaedia
Interlobular
septal thickening • Pseudotumor and congestive cardiac failure - Ganzer Fall bei Radiopaedia
There are many causes of interlobular septal thickening, and this should be distinguished from intralobular septal thickening. Thickening of the interlobular septa can be smooth, nodular or irregular, with many entities able to cause more than one pattern.
Pathology
Causes of septal thickening include
Smooth
- pulmonary edema
- lymphangitic carcinomatosis
- lymphocytic interstitial pneumonia (LIP): often ground glass opacities are also present
- pulmonary hemorrhage: usually ground glass opacities are also present
- acute lung rejection
- lymphoma
- leukemia: pulmonary manifestations of leukemia
- Churg-Strauss syndrome
- Niemann-Pick disease
- congenital lymphangiectasia
- amyloidosis: only sometimes visible
- non-specific interstitial pneumonia (NSIP): usually ground glass opacities are also present
- bronchiectasis
- Erdheim-Chester disease
- yellow nail syndrome
- diffuse pulmonary lymphangiomatosis
Nodular
- lymphangitic carcinomatosis
- Kaposi sarcoma
- lymphoproliferative disorders
- sarcoidosis
- Niemann-Pick disease
- amyloidosis: only sometimes visible
- silicosis
- coal worker's pneumoconiosis (CWP)
Irregular
- sarcoidosis
- idiopathic pulmonary fibrosis: UIP, etc. interlobular septal thickening predominant finding
- asbestosis
- upper lobe predominance: pleuroparenchymal fibroelastosis (though a very rare entity)
Radiographic features
Plain radiograph
- Kerley A lines: long (2-6 cm) lines oriented towards the hila
- Kerley B lines: short ~2 cm line oriented perpendicular to the pleura
See also
- septal pattern in HRCT
- HRCT terminology
Siehe auch:
- Bronchiektasen
- Lungenödem
- Sarkoidose
- Silikose
- Lymphangiosis carcinomatosa
- Churg-Strauss-Syndrom
- Kerley-B-Linien
- Kerley-B-Linien
- Amyloidose
- Lungenblutung
- Asbestose
- Erdheim-Chester-Erkrankung
- non specific interstitial pneumonia (NSIP)
- idiopathische Lungenfibrose
- gewöhnliche interstitielle Pneumonie (UIP)
- lymphozytisch interstitielle Pneumonie
- Interlobulärseptum
- Kaposisarkom
- coal workers pneumoconiosis (CWP)
und weiter:
Assoziationen und Differentialdiagnosen zu verdickte interlobuläre Septen:
gewöhnliche
interstitielle Pneumonie (UIP)
