Elementary Lesions
Perilymphatic Micronodulation
Characteristics
Perilymphatic micronodules are well defined nodules < 3 mm
Their distribution is along the lymphatic vessels:
the fissures and the pleura
the interlobular septa
the vascular and bronchial routes
in the center of the lobule
Diagnostic Orientation
Perilymphatic micronodulations can be associated with different conditions:
sarcoidosis
lymphangitic carcinomatosis
silicosis
berylliosis
diffuse amyloidosis
primary pulmonary lymphoma
lymphoid interstitial pneumonia (Sjögren’s syndrome, autoimmune diseases, HIV)
Micronodules with clear outlines & high densities distributed along fissures, peripheral pleura, and intralobular septa.
Patient presenting an adenocarcinoma in the stomach and micronodulation of the lung with a perilymphatic distribution related to lymphangitic carcinomatosis.
HRCT shows large sarcoid nodules resembling galaxies associated with enlarged sub carinal lymphnodes.
References
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Collège des Enseignants de Pneumologie. Item 206 (ex item 120). Pneumopathies interstitielles diffuses. 2013
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Cottin V, et al. French practical guidelines for the diagnosis and management of idiopathic pulmonary fibrosis - 2017 update. Full-length version. Rev Mal Respir 2017;34:900-68
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Brauner M, et al. Imagerie des pneumopathies diffuses. Press Med 2010 39: 73-84
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Raghu G, et al. Diagnosis of Idiopathic Pulmonary Fibrosis. An Official ATS/ERS/JRS/ALAT Clinical Practice Guideline. Am J Respir Crit Care Med 2018;198:e44-e68