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HRCT : Key findings in Interstitial Lung Diseases Secondary Lobule The basic anatomic unit of pulmonary structure and function. The smallest lung unit that is surrounded by connective tissue septa. It measures about 1-2 cm and is made up of 5-15 pulmonary acini, that contain the alveoli. Secondary Lobule Supplied by a small bronchiole (terminal bronchiole) in the center, that is parallelled by the centrilobular artery. Veins and lymphatics run in the periphery within the interlobular septa. Two lymphatic systems: Central network, runs along the bronchovascular bundle towards the centre of the lobule ; Peripheral network, located within the interlobular septa and along the pleural linings. Secondary Lobule Secondary Lobule Centrilobular area Usually the site of diseases, that enter the lung through the airways ( i.e. hypersensitivity pneumonitis, respiratory bronchiolitis, centrilobular emphysema ). Perilymphatic area Usually the site of diseases, that are located in the lymphatics of in the interlobular septa ( i.e. sarcoid, lymphangitic carcinomatosis, pulmonary edema). These diseases are usually also located in the central network of lymphatics that surround the bronchovascular bundle. Secondary Lobule Secondary Lobule Reticular pattern There are too many lines, either as a result of thickening of the interlobular septa or as a result of fibrosis as in honeycombing . Septal thickening Thickening of the lung interstitium by fluid, fibrous tissue, or infiltration by cells results in a pattern of reticular opacities due to thickening of the interlobular septa. Reticular pattern Smooth septal thickening Usually seen in interstitial pulmonary edema (Kerley B lines); lymphangitic spread of carcinoma or lymphoma and alveolar proteinosis. Nodular or irregular septal Thickening occurs in lymphangitic spread of carcinoma or lymphoma; sarcoidosis and silicosis. Reticular pattern Focal irregular septal thickening
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