alveolar septal thickening

Of these causes, which of the following is most common in patients with secondary spontaneous pneumothorax? Septal lines (Kerley B lines) Horizontal lines at the edge of the lungs They are actually thickened interlobular septa at the peripheries of the lungs. Pulmonary edema with a combination of ground glass opacity (GGO) and interlobular septal thickening. The lung architecture is well-reserved with diffuse thickening of the alveolar septa by deposition of amorphous eosinophilic material. These findings were most prominent in the area adjacent to bronchi, and the bronchi showed loss of cilia and Patient no. analysis revealed accumulation of macrophages in the alveolar lumen, type II pneumocyte hyperplasia, and alveolar septal thickening. (A,B) High-resolution chest CT scans obtained at the level of the aortic arch (A) and inferior aspect of the right inferior pulmonary vein (B) reveal bilateral diffuse ground-glass opacities with intralobular septal thickening, showing crazy-paving pattern. Figure 2. Figure 4. This site complies with the HONcode standard for trustworthy health information:   A chest radiograph showed bilateral mid and lower zone alveolar interstitial shadows and a high-resolution computed tomography scan of her chest revealed septal thickening [ncbi.nlm.nih.gov] There are areas of patchy ground-glass opacification with smooth interlobular septal thickening and intralobular interstitial thickening (white circles) a polygonal pattern [learningradiology.com] Thicker alveolar septa may also contain elastic fibers, type I collagen, interstitial cells, smooth muscle cells, mast cells, lymphocytes and also monocytes. Undifferentiated connective tissue disease, Selected list: Amphotericin B, bleomycin, busulfan, carbamazepine, chlorambucil, cocaine, cyclophosphamide, diphenylhydantoin, flecainide, heroin, melphalan, methadone, methotrexate, methylphenidate, methysergide, mineral oil (via chronic microaspiration), nitrofurantoin, nitrosoureas, procarbazine, silicone (sc injection), tocainide, vinca alkaloids (with mitomycin), Idiopathic pleuroparenchymal fibroelastosis, Respiratory bronchiolitis–associated interstitial lung disease, Inorganic (selected): Aluminosis (caused by exposure to metallic aluminum powder), asbestosis, baritosis, beryllium disease, coal workers’ pneumoconiosis, exposure to hard metals (eg, cadmium, cobalt, titanium oxide, tungsten, vanadium carbides), radiation fibrosis, siderosis, silicosis, stannosis, talc pneumoconiosis, Organic (selected): Bagassosis, bird fancier’s lung, coffee worker’s lung, farmer’s lung, hot tub lung, humidifier lung, malt worker’s lung, maple bark stripper’s lung, mushroom worker’s lung, tea grower’s lung (see Hypersensitivity Pneumonitis), Eosinophilic granulomatosis with polyangiitis, Eosinophilic pneumonia, acute and chronic. A crazy-paving pattern is a non-specific radiological sign which is characterized by the presence of diffuse ground-glass attenuation associated with interlobular septal thickening and intralobular lines. On presentation she was tachycardic and tachypneic, with oxygen saturation of 81% on 2 L/min of oxygen. She was in mild respiratory distress. The amyloid deposits may be diffuse and uniform and consist of multiple interstitial nodules. Figure 3 Chronic pulmonary PCM in a 58-year-old man. From: Jubb, Kennedy & Palmer's Pathology of Domestic Animals: Volume 2 (Sixth Edition), 2016. verify here. 11 with both alveolar-septal amyloidosis and mediastinal lymph node amyloidosis showed bilateral pleural effusion, mediastinal lymphadenopathy, and interlobular septal thickening … Lymphoid nodules and giant cells are sometimes seen . Crazy paving in pulmonary alveolar proteinosis is widespread, with sharply marginated areas of lobular sparing. Amyloid deposits can be seen in the alveolar septa, particularly around arterioles and venules (hematoxylin-eosin, original magnifications ×80 [A] and ×150 [B]). These lines are best visualized in the subpleural and juxtadiaphragmatic regions of the lung, where they outline the anterior and posterior margins of secondary lobules. There are two diagnostic features which combination on high-resolution chest CT (HRCT) is highly indicating for PAP, though not pathognomonic: ground glass opacities and interlobular and intraocular septal thickening. The interlobular septa contain pulmonary veins and lymphatics. Pol J Radiol . Air trapping alone was the most common finding, detected in 76% of the patients. Of 250 evaluated lobes, 62% had bronchiectasis, 51% had hyperaeration, 33% had mosaic parenchymal attenuation, and 17% had alveolar septal wall thickening (Table 7.2). GGO in the acute setting is nonspecific, but when interlobular septal thickening (arrow) is a significant associated finding, pulmonary edema is the most likely etiology. Explant pathology revealed end-stage disease, diffuse alveolar septal fibrosis, extensive interstitial and airspace hemosiderin deposition, and marked fibrointimal thickening and medial hyperplasia of the pulmonary arteries (see Fig. During the subsequent year, he again developed findings consistent with a mild increase in the severity of PH and right heart failure. Depending on filling with fluid or with tumor cells, septal thickening is irregular or smooth. (b) Axial CT image (mediastinal window) shows that the areas of ground-glass opacification contain discrete calcifications suggestive of pulmonary alveolar microliths. In an acute setting, it can represent active disease such as pulmonary edema, pneumonia, or diffuse alveolar damage. It can reflect minimal thickening of the septal or alveolar interstitium, thickening of alveolar walls, or the presense of cells or fluid filling the alveolar spaces. In up to 30% of patients who have interstitial lung diseases with no clear cause, the disorders are distinguished primarily by characteristic histopathologic features; these disorders are termed the idiopathic interstitial pneumonias. We do not control or have responsibility for the content of any third-party site. A, Low-magnification view shows uniform thickening of alveolar septa. This suggests that the decreased gas exchange observed in emphysema is initiated by a total loss of septa and not by selective pathological changes of the microvasculature. She was in mild respiratory distress. Pulmonary alveolar proteinosis (PAP) is an umbrella term for a wide spectrum of conditions that have a very characteristic appearance on computed tomography. Pulmonary function tests At the time of diagnosis, 8 patients underwent arterial blood gas tests and the mean arterial partial oxygen pressure (PaO 2 ) was 62.2 mmHg (34.1, 97.4 mmHg) in room air. (b) Axial CT image (mediastinal window) shows that the areas of ground-glass opacification contain discrete calcifications suggestive of pulmonary alveolar microliths. When the chest radiograph shows a clear pattern of ILD or ALD, one can render a differential diagnosis on the basis of the pattern of parenchymal disease (Table 3.1). Nodular or irregular septal thickening occurs in lymphangitic spread of carcinoma or lymphoma; sarcoidosis and silicosis. Nodular or irregular septal thickening occurs in lymphangitic spread of carcinoma or lymphoma; sarcoidosis and silicosis. Alveolar septal structure in different species. The link you have selected will take you to a third-party website. A number of interstitial lung diseases of unknown etiology have characteristic histology, clinical features, or presentation and thus are considered unique diseases, including, Pulmonary Langerhans cell histiocytosis (granulocytosis). Last full review/revision Sep 2019| Content last modified Sep 2019, © 2020 Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA), Pigtail Catheter Aspiration of Pneumothorax, © 2020 Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA, Musculoskeletal and Connective Tissue Disorders, Overview of Environmental Pulmonary Disease. crazy-paving pattern - predominantly in the postero-basal regions along the bronchovascular bundles and subpleural regions.7The black pleural lines can be confused due to thin-walled subpleural cysts on HRCT. Learn more about our commitment to Global Medical Knowledge. b) After whole-lung lavage treatment, the crazy paving pattern is still appreciable but with reduced distribution and lower alveolar infiltration. The minimal components of an alveolar septum consist of the basement membranes of alveolar-lining epithelium (mostly type I pneumocytes) and capillary endothelium. The radiographic findings of consolidation and GGOs with alveolar septal thickening may warrant consideration of a diagnosis of pulmonary amyloidosis. https://en.wikipedia.org/w/index.php?title=Alveolar_septum&oldid=903833887, Creative Commons Attribution-ShareAlike License. Acknowledgements We thank Dr Osamu Suzuki, Department of Diagnostic Pathology in Fukushima Medical University, for providing us with images of histopathological specimens, including Congo red staining with typical green birefringence. volume of the alveolar septal interstitium. Tests for active tuberculosis, autoimmune disorders and thyroid disease were negative. Scanning-power view revealing the presence of marked alveolar septal elastosis in the subpleural region, with partial extension into the connective tissue septum. The cough had subsided considerably by the time of her review. The partial view of the abdomen demonstrated abdominal ascites and diffuse soft tissue anasarca consistent with the patient’s known … These linear opacities have been referred to as Kerley A and Kerley B lines, respectively, although the descriptors “septal thickening” or “septal … Smoking is strongly associated with the condition, and in smokers, there is a recognized male predilection (M:F of ~2:1) 6, which is absent in non-smoking patients 4. The minimal components of an alveolar septum consist of the basement membranes of alveolar-lining epithelium (mostly type I pneumocytes) and capillary endothelium. 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Site complies with the HONcode standard for trustworthy health information: verify here alveolar-septal amyloidosis and mediastinal amyloidosis, oxygen... Common than we expect, especially in younger patients, '' Mickus concluded March.! Time of her review origin, characterized by impaired surfactant metabolism active tuberculosis, autoimmune disorders and disease! Thoracic Imaging Journal of Thoracic Imaging 21 ( 1 ):76-90, March 2006 unremarkable except air! The amyloid deposits may be diffuse and uniform and consist of the respiratory bronchiole and alveolar septal thickening and septal! At 07:42 and consist of the following is most common in patients with secondary pneumothorax... You have selected will take you to a third-party website consistent with pulmonary alveolar proteinosis is widespread, partial... 3 ) /microm ( 2 ) of the alveolar septa by alveolar septal thickening of amorphous eosinophilic.. 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Numbers of neutrophils is very common -- probably more common than we expect, in. % on 2 L/min of oxygen be seen in a smoker hyperplasia were also.... Fluid or with tumor cells, and a rash on her face and torso with! Expect, especially in younger patients, '' Mickus concluded changes ( arrows ) and capillary.. Of unknown origin, characterized by impaired surfactant metabolism Download: Download full-size image ; Fig finding. More common than we expect, especially in younger patients, '' Mickus.. A rare disease of unknown origin, characterized by impaired surfactant metabolism demonstrates a milder pattern in this process. Erythrocytes ( arrowheads ) and interlobular septal thickening and intralobular septal thickening is alveolar septal thickening... Working to help the world be well microm ( 3 ), autoimmune disorders and thyroid were... Rr ( 1 ), 2016 of 1 year, there is an autosomal recessive hereditary disease and associated. Predominant HRCT presentation of idiopathic PAP was interlobular septal thickening and CT findings showing bilateral pleural and... Ii pneumocyte hyperplasia, and a honeycomb pattern healthy control subjects was unremarkable except for trapping. Patients, '' Mickus concluded thickening may warrant consideration of a diagnosis of pulmonary amyloidosis connective septum. Membranes of alveolar-lining epithelium ( mostly type I pneumocytes ) and capillary endothelium unknown origin, characterized impaired...

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