Chest Imaging

Honeycombing

extensive end-stage pulmonary fibrosis resulting in lung destruction and obliteration of acinar architecture because of its characteristic appearance. Cystic spaces are present, usually ranging from several mm to 1 cm in diameter, characterized by thick, clearly definable fibrous walls, typically lined by bronchiolar epithelium. They often have a subpleural predominance. On plain radiographs, honeycombing results in a reticular pattern which is usually most evident peripherally and in the costophrenic angles. On HRCT, the cystic air-spaces of honeycombing commonly share walls, are predominantly subpleural, and occur in several layers (Fig.1). It is most commonly caused by idiopathic pulmonary fibrosis, collagenvascular diseases, end-stage hypersensitivity pneumonitis and asbestosis.

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Fig.1

HRCT scan in a patient with idiopathic pulmonary fibrosis showing typical honeycombing predominant in the subpleural areas of the lung bases.
Honeycombing, Fig.1