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Chest Imaging

Centrilobular nodules

nodules predominating in the centres of secondary pulmonary lobules, often in relation to centrilobular bronchioles or arteries. They may be seen as a cluster or rosette of nodules, surrounding centrilobular vessels or occurring in relation to centrilobular structures. On plain radiographs centrilobular nodules are often referred to as acinar. On high resolution CT (HRCT), centrilobular nodules spare the pleural surfaces, and the most peripheral nodules visible are usually 510 mm from the pleural surface (Fig.1). Centrilobular nodules are most common in patients with bronchiolar diseases. Their differential diagnosis includes endobronchial spread of infection (including tuberculosis, Mycobacterium avium-intracellulare complex, bacterial bronchopneumonia and viral infections), airway inflammation (cystic fibrosis, bronchiectasis), endobronchial spread of tumour, hypersensitivity pneumonitis, bronchiolitis obliterans organizing pneumonia (BOOP) and respiratory bronchiolitis.

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Fig.1

Prone high-resolution CT scan in a man with bacterial bronchopneumonia, who shows centrilobular nodules in the lower lobes.
Centrilobular nodules, Fig.1