Honeycomb lung DDx

DIFFERENTIAL DIAGNOSIS

Disease etiologyDistributionComment
Usual Interstitial Pneumonia (UIP)Lower lobeIncludes idiopathic pulmonary fibrosis (UIP), asbestosis, aspiration, and connective tissue disorders
NSIPLower lobeIncludes fibrotic NSIP, connective tissue disorders
Other idiopathic interstitial pneumonia
AIPVariableAssociated with respiratory failure, diffuse ground-glass opacity and consolidation
DIPVariableSmokers with multifocal or diffuse ground-glass opacity
Hypersensitivity pneumonitisMid-lungsTends to spare extreme bases, unlike UIP
SarcoidosisUpper lobeMay see associated peri-lymphatic nodules
Radiation injuryVariableDepends on port; may recognize abrupt margins and non-anatomic distribution
ARDS (post-recovery)Anterior lungPosterior atelectasis in ARDS may be protective from oxygen toxicity, allowing preferential damage to anterior lung

  • UIP: Usual Interstitial Pneumonia
  • NSIP (NIP): Nonspecific Interstitial Pneumonia
  • AIP: Acute Interstitial Pneumonia 
  • DIP: Desquamative Interstitial Pneumonia

References and Links

  • Arakawa H, Honma K. Honeycomb lung: history and current concepts. AJR Am J Roentgenol. 2011 Apr;196(4):773-82. PMID: 21427324.

CCC 700 6

Critical Care

Compendium

Chris is an Intensivist and ECMO specialist at the Alfred ICU in Melbourne. He is also the Innovation Lead for the Australian Centre for Health Innovation at Alfred Health and Clinical Adjunct Associate Professor at Monash University. He is a co-founder of the Australia and New Zealand Clinician Educator Network (ANZCEN) and is the Lead for the ANZCEN Clinician Educator Incubator programme. He is on the Board of Directors for the Intensive Care Foundation and is a First Part Examiner for the College of Intensive Care Medicine. He is an internationally recognised Clinician Educator with a passion for helping clinicians learn and for improving the clinical performance of individuals and collectives.

After finishing his medical degree at the University of Auckland, he continued post-graduate training in New Zealand as well as Australia’s Northern Territory, Perth and Melbourne. He has completed fellowship training in both intensive care medicine and emergency medicine, as well as post-graduate training in biochemistry, clinical toxicology, clinical epidemiology, and health professional education.

He is actively involved in in using translational simulation to improve patient care and the design of processes and systems at Alfred Health. He coordinates the Alfred ICU’s education and simulation programmes and runs the unit’s education website, INTENSIVE.  He created the ‘Critically Ill Airway’ course and teaches on numerous courses around the world. He is one of the founders of the FOAM movement (Free Open-Access Medical education) and is co-creator of litfl.com, the RAGE podcast, the Resuscitology course, and the SMACC conference.

His one great achievement is being the father of two amazing children.

On Twitter, he is @precordialthump.

| INTENSIVE | RAGE | Resuscitology | SMACC

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