Centrilobular lung nodules
Citation, DOI, disclosures and article data
Citation:
Weerakkody Y, Chieng R, Knipe H, et al. Centrilobular lung nodules. Reference article, Radiopaedia.org (Accessed on 07 Mar 2025) https://doi.org/10.53347/rID-21733
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rID:
21733
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Disclosures:
At the time the article was created Yuranga Weerakkody had no recorded disclosures.
View Yuranga Weerakkody's current disclosures
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At the time the article was last revised Raymond Chieng had no financial relationships to ineligible companies to disclose.
View Raymond Chieng's current disclosures
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Synonyms:
- Centrilobular nodular opacities
- Centrilobular nodule
- Centri-lobular nodules
- Centri-lobular nodule
- Centrilobular lung nodule
- Centrilobular pulmonary nodules
- Centrilobular pulmonary nodule
- Centrilobular nodules - lung
- Centrilobular nodularity - lung
- Centrilobular lung nodules
Centrilobular lung nodules are an HRCT chest imaging descriptor for 5-10 mm lung nodules anatomically located centrally within secondary pulmonary lobules. The term is applied based on the nodule's location, not its morphology; they may appear as well-defined solid or poorly-defined ground glass nodules. If extremely small, they are termed centrilobular micronodules.
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Pathology
Etiology
Centrilobular nodules can be observed in a wide variety of lung pathology. In particular, pathologies involving the bronchioles and the arterioles (i.e., bronchiolitis and vasculitis), as both are located centrally in the secondary pulmonary lobule. Specific conditions include:
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infection with endobronchial spread
airway spread of tuberculosis
airway spread of non-tuberculous mycobacterial infection
respiratory bronchiolitis (RB) and respiratory bronchiolitis interstitial lung disease (RB-ILD) 5
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pulmonary vasculitides (GGO may correspond to perivascular inflammation or hemorrhage)
pulmonary arterial hypertension (particularly PVOD)
lung adenocarcinoma with airway spread
metastatic pulmonary calcification (increased density, may be calcified)
When centrilobular nodules are interspersed with linear and branching densities, it is then termed a tree-in-bud pattern.
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Radiographic features
CT
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.
See also
Quiz questions
References
- 1. Kazerooni E. High-Resolution CT of the Lungs. AJR Am J Roentgenol. 2001;177(3):501-19. doi:10.2214/ajr.177.3.1770501 - Pubmed
- 2. Franquet T, Müller N, Giménez A, Guembe P, de La Torre J, Bagué S. Spectrum of Pulmonary Aspergillosis: Histologic, Clinical, and Radiologic Findings. Radiographics. 2001;21(4):825-37. doi:10.1148/radiographics.21.4.g01jl03825 - Pubmed
- 3. Rossi S, Franquet T, Volpacchio M, Giménez A, Aguilar G. Tree-In-Bud Pattern at Thin-Section CT of the Lungs: Radiologic-Pathologic Overview. Radiographics. 2005;25(3):789-801. doi:10.1148/rg.253045115 - Pubmed
- 4. Engelke C, Schaefer-Prokop C, Schirg E, Freihorst J, Grubnic S, Prokop M. High-Resolution CT and CT Angiography of Peripheral Pulmonary Vascular Disorders. Radiographics. 2002;22(4):739-64. doi:10.1148/radiographics.22.4.g02jl01739 - Pubmed
- 5. Park J, Brown K, Tuder R, Hale V, King T, Lynch D. Respiratory Bronchiolitis-Associated Interstitial Lung Disease: Radiologic Features with Clinical and Pathologic Correlation. J Comput Assist Tomogr. 2002;26(1):13-20. doi:10.1097/00004728-200201000-00003 - Pubmed
- 6. Webb W, Higgins C. Thoracic Imaging. (2010) ISBN: 9781605479767 - Google Books
- 7. Boitsios G, Bankier A, Eisenberg R. Diffuse Pulmonary Nodules. AJR Am J Roentgenol. 2010;194(5):W354-66. doi:10.2214/AJR.10.4345 - Pubmed
- 8. Winningham P, Martínez-Jiménez S, Rosado-de-Christenson M, Betancourt S, Restrepo C, Eraso A. Bronchiolitis: A Practical Approach for the General Radiologist. Radiographics. 2017;37(3):777-94. doi:10.1148/rg.2017160131 - Pubmed
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Cases:
- Tropical pulmonary eosinophilia
- Fibrotic hypersensitivity pneumonitis
- Pulmonary tuberculosis
- Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (DIPNECH)
- Excipient lung disease
- Miliary tuberculosis with spondylitis
- Sarcoidosis - perilymphatic nodular thicknening
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- Infectious bronchiolitis
- Respiratory bronchiolitis-interstitial lung disease (RB-ILD)
- Miliary tuberculosis
- Pulmonary tuberculosis with COPD
- Bronchiolitis
- Tree-in-bud appearance
- Hypersensitivity pneumonitis
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