CTICasesSeptal Lakes (Lymphatic Pearls) in Pulmonary Edema
Imaging findings
Serial CT scans in a patient with leukemia demonstrate smooth interlobular septal thickening, pleural effusions, and a series of small, discrete, bead-like nodules along the interlobular septa. Follow-up scans after aggressive diuresis show rapid and complete resolution of both the septal thickening and the nodular densities.
Key takeaways
Septal lakes (formerly referred to as lymphatic pearls) represent localized focal dilations of the pulmonary lymphatics or venules within the interlobular septa. In patients with leukemia, lymphoma, or fluid overload, these benign, transient nodules can easily mimic lymphangitic carcinomatosis or interstitial infection, but their rapid response to diuresis confirms their hydrostatic, edema-related etiology.
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