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Home | CCC | Interstitial lung markings on CXR DDx

Interstitial lung markings on CXR DDx

by Dr Chris Nickson, last update April 24, 2019

Overview

Increased interstitial markings seen on chest x-ray may also be referred to as a fine reticular pattern

Features

Peribronchovascular connective tissue thickening

  • Peribronchial cuffing (bronchus on-end)
  • “Tram tracks” (side view of bronchus)
  • Blurred vascular markings (indistinct margins)

Septal connective tissue thickening

  • Thickened interlobular septa (called Kerley B or septal lines)
  • Fine reticular pattern (Kerley C lines = superimposed Kerley B lines)
  • Kerley A lines (thickened deep intraparenchymal septal bands that radiate from the hilum in the upper lungs)
  • Thickened interlobar fissures (subpleural connective tissue thickening)

 Causes

Acute—often associated with airspace filling

  • 
Interstitial pulmonary edema
  • 
Interstitial pneumonitis — viral, mycoplasma

Chronic interstitial lung diseases

  • Neoplastic infiltration (lymphangitic carcinomatosis, lymphoma)
  • Sarcoidosis
  • Collagen-vascular diseases
Interstitial pneumonitis
  • Idiopathic pulmonary fibrosis
  • Pneumoconiosis (silicosis, asbestosis)

CCC 700 6

Critical Care

Compendium

…more CCC

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About Dr Chris Nickson

An oslerphile emergency physician and intensivist suffering from a bad case of knowledge dipsosis. Key areas of interest include: the ED-ICU interface, toxicology, simulation and the free open-access meducation (FOAM) revolution. @Twitter | INTENSIVE| SMACC

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