As with the other disorders discussed above, the HRCT findings of end-stage sarcoidosis can show overlap with IPF, including irregular reticulation,
traction bronchiectasis, and honeycombing.
Traction bronchiectasis in end-stage pulmonary fibrosis.
Small branching airways that are adjacent to scars can be diagnosed confidently as
traction bronchiectasis, but at what scale does
traction bronchiectasis end, and end-stage lung disease begin?
Four patients had radiographic features of usual interstitial pneumonia (UIP) on high-resolution computerized tomographic scan, with bibasilar reticular infiltrates with
traction bronchiectasis and subpleural honeycomb change.
Ground glassing was observed in 24(24%) patients while bronchiectatic changes were evident in another 24(24%) cases with 12 patients showing
traction bronchiectasis. There were cavities in 16(16%) of which 8(50%) cases had multiple cavities and 4(25%) had single cavity, 2(12.5%) had heterogenous densities within and another 2(12.5%) cases demonstrated the meniscus sign.
Other CT findings were as follows: Air trapping in 9/24 (37.5%) [Figure 2], reticulation in 8/24 (33.3%), and
traction bronchiectasis in 2/24 (8.3%).
Higher levels of seven or more ACPAs were significantly more common in patients with reticulation, honeycombing, or
traction bronchiectasis than in those with no ILD (40% vs.
Higher number of
traction bronchiectasis were detected on HRCT thorax method as compared to chest X-ray but it was not statistically significant (P>0.05).
(5,6) Although radiographic findings, including bibasilar fibrosis, ground-glass opacities, interlobular reticulation, and
traction bronchiectasis, have been described, the corresponding histopathology has been poorly documented.
An extended and coarse subpleural reticular pattern is noted associated with
traction bronchiectasis and bronchiolectasis as well as with honeycombing.
The lung abnormalities included nondependent ground-glass or reticular abnormalities, diffuse centrilobular nodularity, nonemphysematous cysts, honeycombing, and
traction bronchiectasis. Interstitial lung abnormalities were associated with both a decrease in total lung capacity and a lesser amount of emphysema.
UIP--B/L subpleural, basal and lower lobe predominant honeycombing, reticulations with
traction bronchiectasis.