The exuberant honeycombing sign is an HRCT finding typically observed in the context of usual interstitial pneumonia. This sign is characterized by the presence of extensive honeycomb-like cyst formation within the lungs, comprising more than 70% of the fibrotic portions of the lungs. In other words, there is relatively little (<30%) fibrotic but not-honeycombed lung parenchyma 1-3.
In the context of usual interstitial pneumonia, the presence of the exuberant honeycombing sign, along with the anterior upper lobe sign and the straight-edge sign, has a fairly high specificity but moderate sensitivity for being the result of connective tissue disease-associated interstitial lung disease (CTD-ILD) rather than idiopathic pulmonary fibrosis (IPF) 1,3.
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