Both SRIF and UIP have a subpleural
distribution; however, SRIF shows a predilection for the upper lobes, whereas UIP is commonly characterized as having predominantly lower lobe involvement, with the additional radiographic findings of traction bronchiectasis and honeycomb change.
PPFE is a rare condition and characterized by fibroelastic thickening in the pleura and subpleural
lung parenchyma especially in the upper lobes.
Caption: Figure 4: CT chest scan with a 31 cm dilation of the pulmonary trunk with a partial occlusion of the left pulmonary artery and a complete occlusion of the right pulmonary artery by a fluid attenuation lesion and a subpleural
cyst of the inferior lungular segment measuring 19 mm.
However, in patients with small subpleural
lesions, a better diagnostic yield has been reported with an indirect approach that involves a longer intrapulmonary needle path (28, 32).
High-resolution computed tomography findings of pulmonary involvement (n=48) in arsenic exposed patients, All values are expressed as number (percentage) Diffuse involvement 9 (18.8) Bronchiectasis Grade 0 - Grade 1 6 (12.5) Grade 2 - Grade 3 - Bulla-emphysema 13 (27.1) Pulmonary nodules 31 (64.5) Location of pulmonary nodules Upper zone 12 (38.7) Middle zone 4 (12.9) Lower zone 9 (29.0) All three zones 6 (19.4) Unilateral 21 (67.7) Bilateral 10 (32.3) Pleural 1 (3.2) Subpleural
8 (25.8) Parenchymal 17 (54.8) Subpleural
+ parenchymal 5 (16.1) TABLE 3.
CT image shows subpleural
irregularity in the right upper lobe (black arrow) and progression of fibrosis and bronchiectasis in the left upper lobe (white arrow).
Spontaneous pneumothorax is sub-classified as primary and secondary.3,4 Primary spontaneous pneumothorax (PSP) that results from spontaneous rupture of a subpleural
bleb or bulla occurs predominantly in young, thin males without underlying lung disease.
NSIP, the most common pattern of fibrosis seen in DI-ILD, is characterized by basal-predominant subpleural
reticular opacities, an absence of honeycombing pattern and scattered ground glass opacities.1 An IPF pattern is distinguished from NSIP in that it is associated with honeycombing and traction bronchiectasis and is more likely to be subpleural
(15) The consolidation is typically predominant in the middle and lower lung zones with a subpleural
or peribronchovascular distribution.
It is proposed that it is inflammatory in nature, causing newly formed vessels bridging subpleural
pulmonary veins and intercostal veins through pleural adhesions .
HRCT of the lungs showed high attenuation, increasing from the apex to the lung base, ground glass opacities, and subpleural
cysts [Figure 2].