Honeycombing (lungs)

Last revised by Rohit Sharma on 19 May 2024

Citation, DOI, disclosures and article data

Citation:

Amini B, Sharma R, Silverstone L, et al. Honeycombing (lungs). Reference article, Radiopaedia.org (Accessed on 02 Jun 2024) https://doi.org/10.53347/rID-1462

DOI:

https://doi.org/10.53347/rID-1462

Permalink:

https://radiopaedia.org/articles/1462

rID:

1462

Article created:

2 May 2008, Behrang Amini

Disclosures:

At the time the article was created Behrang Amini had no recorded disclosures.

View Behrang Amini's current disclosures

Last revised:

19 May 2024, Rohit Sharma ◉

Disclosures:

At the time the article was last revised Rohit Sharma had no financial relationships to ineligible companies to disclose.

View Rohit Sharma's current disclosures

Revisions:

26 times, by 14 contributors - see full revision history and disclosures

Systems:

Chest

Sections:

Signs

Tags:

lung

Synonyms:

Honeycomb lung
Honeycombed lung
Honeycomb lungs
Honeycombed lungs
Honey combing

Honeycombing is a CT imaging descriptor referring to clustered cystic air spaces (between 3 and 10 mm in diameter, but occasionally as large as 2.5 cm) that are usually subpleural, peripheral, and basal in distribution. They can be subdivided into:

The walls of the cysts are well-defined and often thick (1-3 mm) ⁴. They represent an irreversible finding commonly seen in diffuse pulmonary fibrosis (usual interstitial pneumonia (UIP)).

Honeycombing and traction bronchiolectasis can be difficult to distinguish - not surprising since traction bronchiolectasis is thought to progress to honeycombing. Honeycomb cysts are usually similar in size, <5mm, clustered in a row or stacked and with shared walls. They are first seen adjacent to the pleura, usually in the basal lower lobes in areas of dense fibrosis ¹⁰.

History and etymology

The term “honeycomb lung” is thought to have originated in the 19^thcentury in Germany and is thought to have first appeared in 1949 in a study by N Oswald and T Parkinson ⁵.

Differential diagnosis

traction bronchiolectasis
in some situations
- paraseptal emphysema (single layer of larger thin-walled juxta-pleural cyst-like spaces in non-fibrotic lung with upper lobe predominance) ¹⁰
- airspace enlargement with fibrosis/smoking-related interstitial fibrosis (larger multi-layered or confluent thin-walled cysts, or cysts separated by normal lung which often spare the subpleural lung and lower zones) ¹⁰
- paracicatricial emphysema ³
airspace consolidation in the presence of pulmonary emphysema ⁸

Quiz questions

References

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