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Pulmonary Edema with Septal Lakes (Lymphatic Pearls)

Imaging findings

Chest CT demonstrates interstitial thickening with focal, round, fluid-density expansions along the interlobular septa of the left upper lobe, representing "septal lakes" or lymphatic pearls. Follow-up imaging shows complete resolution of the interstitial thickening and these localized septal expansions.

Key takeaways

Septal lakes (or lymphatic pearls) represent localized, transient dilations of lymphatic channels within the interlobular septa of patients experiencing severe pulmonary edema. These findings should be recognized as a benign, reversible feature of fluid overload to avoid an incorrect diagnosis of nodular interstitial disease or pulmonary nodules.

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