Honeycombing on CT; its definition, pathologic correlation, and future direction of its diagnosis

Takeshi Johkoh; Fumikazu Sakai; Satoshi Noma; Masanori Akira; Kiminori Fujimoto; Takeyuki Watadani; Yukihiko Sugiyama

doi:10.1016/j.ejrad.2013.05.012

Honeycombing on CT; its definition, pathologic correlation, and future direction of its diagnosis

Eur J Radiol. 2014 Jan;83(1):27-31. doi: 10.1016/j.ejrad.2013.05.012. Epub 2013 Jun 24.

Authors

Takeshi Johkoh¹, Fumikazu Sakai², Satoshi Noma³, Masanori Akira⁴, Kiminori Fujimoto⁵, Takeyuki Watadani⁶, Yukihiko Sugiyama⁷

Affiliations

¹ Department of Radiology, Kinki Central Hospital of Mutual Aid Association of Public School Teachers, 3-1 Kurumazuka, Itami, Hyogo, 664-8533, Japan. Electronic address: johkoht@aol.com.
² Department of Diagnostic Radiology, Saitama International Medical Center, Saitama Medical University, Hidaka, Japan.
³ Department of Radiology, Tenri Hospital, Tenri, Japan.
⁴ Department of Radiology, National Hospital Organization Kinki-Chuo Chest Medical Center, Sakai, Japan.
⁵ Department of Radiology and Center for Diagnostic Imaging, Kurume University School of Medicine, Kurume, Japan.
⁶ Department of Radiology, University of Tokyo, Tokyo, Japan.
⁷ Department of Internal Medicine, Jichi Medical University, Shimotsuke, Japan.

PMID: 23806532
DOI: 10.1016/j.ejrad.2013.05.012

Abstract

Honeycombing on CT is the clue for the diagnosis of usual interstitial pneumonia (UIP) and its hallmark. According to the ATS-ERS-JRS-ALAT 2010 guideline, the patients with honeycombing on CT can be diagnosed as UIP without surgical biopsy. On CT scans, it is defined as clustered cystic airspaces, typically of comparable diameters of the order of 3-10mm, which are usually subpleural and have well-defined walls. Pathologically, honeycombing consists of both collapsing of multiple fibrotic alveoli and dilation of alveolar duct and lumen Although the definition of honeycombing seems to be strict, recognition of honeycombing on CT is various among each observer Because typical honeycombing is frequently observed in the patients with UIP, we should judge clustered cysts as honeycombing when a diagnosis of UIP is suspected.

Keywords: CT; Honeycombing; Pathologic correlation; Usual interstitial pneumonia.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Diagnosis, Differential
Forecasting
Humans
Idiopathic Pulmonary Fibrosis / classification*
Idiopathic Pulmonary Fibrosis / diagnosis*
Lung / diagnostic imaging*
Lung / pathology*
Terminology as Topic*
Tomography, X-Ray Computed / methods*
Tomography, X-Ray Computed / trends*