Centrilobular lung nodules refer to an HRCT chest imaging descriptor for small 5-10 mm lung nodules which are anatomically located centrally within secondary pulmonary lobules. The term is applied on the basis of location of the nodule and not its morphology, that is they may be well-defined or poorly-defined ground glass in appearance. If extremely small they are termed centrilobular micronodules.
Centrilobular nodules can be observed in a wide variety of lung pathology. They are usually seen with a bronchiolitis (i.e. with bronchiolar or peribronchiolar abnormalities). Specific conditions include:
- infection with endobronchial spread
- bronchoalveolar carcinoma with airway spread
- subacute hypersensitivity pneumonitis 1
- respiratory bronchiolitis interstitial lung disease (RB-ILD) 5
- pulmonary vasculitides
When centrilobular nodules are interspersed with linear and branching densities, it is then termed a tree-in-bud pattern.
On HRCT chest, centrilobular nodules are typically found around the small airways and spare the subpleural surfaces. They are typically at least 5-10 mm away from the pleural surfaces ref.
- 1. Kazerooni EA. High-resolution CT of the lungs. AJR Am J Roentgenol. 2001;177 (3): 501-19. AJR Am J Roentgenol (full text) - Pubmed citation
- 2. Franquet T, Müller NL, Giménez A et-al. Spectrum of pulmonary aspergillosis: histologic, clinical, and radiologic findings. Radiographics. 2001;21 (4): 825-37. Radiographics (full text) - Pubmed citation
- 3. Rossi SE, Franquet T, Volpacchio M et-al. Tree-in-bud pattern at thin-section CT of the lungs: radiologic-pathologic overview. Radiographics. 2005;25 (3): 789-801. Radiographics (full text) - doi:10.1148/rg.253045115 - Pubmed citation
- 4. Engelke C, Schaefer-Prokop C, Schirg E et-al. High-resolution CT and CT angiography of peripheral pulmonary vascular disorders. Radiographics. 2002;22 (4): 739-64. Radiographics (full text) - Pubmed citation
- 5. Park JS, Brown KK, Tuder RM et-al. Respiratory bronchiolitis-associated interstitial lung disease: radiologic features with clinical and pathologic correlation. J Comput Assist Tomogr. 2002;26 (1): 13-20. Pubmed citation
- 6. Webb WR, Higgins CB. Thoracic Imaging. Lippincott Williams & Wilkins. (2010) ISBN:1605479764. Read it at Google Books - Find it at Amazon
- 7. Boitsios G, Bankier AA, Eisenberg RL. Diffuse pulmonary nodules. AJR Am J Roentgenol. 2010;194 (5): W354-66. AJR Am J Roentgenol (full text) - doi:10.2214/AJR.10.4345 - Pubmed citation
- 8. Peter J. Winningham, Santiago Martínez-Jiménez, Melissa L. Rosado-de-Christenson, Sonia L. Betancourt, Carlos S. Restrepo, Andrés Eraso. Bronchiolitis: A Practical Approach for the General Radiologist. (2017) RadioGraphics. 37 (3): 777-794. doi:10.1148/rg.2017160131 - Pubmed