Monday, May 2, 2011

Perilymphatic Distribution

The perilymphatic pattern of pulmonary nodules refers to distribution along lymphatics of the interlobular septa and surrounding the bronchovascular bundle. Nodules are seen at pleural surfaces, interlobular septa and the peribronchovascular interstitium. They can be seen in:
  • Sarcoidosis: Look for hilar and mediastinal adenopathy.
  • Inhalational: Silicosis, coal-worker's pneumoconiosis.
  • Lymphangitic spread of carcinoma:
  • Kaposi sarcoma (shown above): In an immunocompromised patient, peribronchovascular distribution favors a diagnosis of Kaposi sarcoma over lymphoma and infection.
  • Lymphoma:


Edinburgh KJ, Jasmer RM, Huang L, Reddy GP, Chung MH, Thompson A, Halvorsen RA Jr, Webb RA. Multiple pulmonary nodules in AIDS: usefulness of CT in distinguishing among potential causes. Radiology. 2000 Feb;214(2):427-32.

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