Honeycombing and bronchiolectasis
may be present in the fibrotic areas, but these findings are generally central in distribution, unlike the subpleural distribution of honeycombing that is characteristic of the UIP pattern.
A subpleural reticular pattern associated with focal thickening of the pleura and traction bronchiectasis and bronchiolectasis is also noted.
An extended and coarse subpleural reticular pattern is noted associated with traction bronchiectasis and bronchiolectasis as well as with honeycombing.
Retrospective review of HRCT scans on vitrea workstation was done by four qualified radiologists for presence or absence of ground glass haze, airspace consolidation, reticulation and honeycombing, extent and zonal distribution of HRCT findings, severity of bronchiolectasis
/ bronchiectasis, architectural distortion or ancillary findings such as lymphadenopathy and associated pleural or cardiac changes.
Bilateral extensive septal thickennings, reticulonodular appearance, patchy bronchiectasis, bronchiolectasis and peribronchial thickennings were found on high-resolution thoracal computarized tomography.
High resolution thoracic computarized tomography (HRCT) revealed bilateral diffuse septal thickennings, reticulonodular appearance, bronchiectasis from place to place, bronchiolectasis and peribronchial thickennings (Figure 2).
A chest x-ray showed generalized bronchiolectasis
, but no consolidation.
11) Radiologic features of disease advancement to the proliferative and fibrotic phases are characterized by traction bronchiolectasis
or bronchiectasis within areas of increased attenuation on high-resolution computerized tomography scans.
In my experience, cystic bronchiolectasis
can be seen in computed tomography scans without honeycombing, and many of these cases will prove to have UIP on biopsy.
Histologically, such a disorder may be identified in the periphery of the lung, based on the presence of dense, hyalinized, type-I collagen; smooth muscle hyperplasia; and bronchiolectasis
The typical radiologic findings in PSS-associated ILD consist of bibasilar ground-glass attenuation, superimposed on mild architectural distortion, reticulation, and variable traction bronchiolectasis
with a homogeneous appearance correlating with NSIP (Figure 5).
Minimal architectural distortion, such as traction bronchiolectasis
and lobular distortion in the areas of the consolidation, can occur in chronic cases.