HRCT shows a possible UIP pattern with:
  • Traction bronchiectasis (minimal) 
  • Centrilobular emphysema
  • Paraseptal emphysema / DD honeycombing
  • Reticulation (only around emphysema)
The differential diagnosis of a UIP pattern remains difficult and sometimes cannot be “solved”.
In some situations a paraseptal emphysema is very difficult to distinguish from honeycombing. In these cases searching for coincidence with centrilobular emphysema could be helpful.

  1. Raghu, et al. An official ATS/ERS/JRS/ALAT Statement: Idiopathic pulmonary fibrosis: Evidence-based guidelines for diagnosis and management. Am J Respir Crit Care Med. 2011 Mar 15;183(6):788-824.
Provided by Prof. Heussel and PD Kreuter (Thoraxklinik Heidelberg, Germany)