CTICasesInterstitial Lung Edema with Lymphatic Pearls
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Imaging findings
This patient, undergoing stem cell transplantation, initially showed mild interstitial edema and pleural fluid that subsequently resolved. A follow-up CT demonstrated florid signs of interstitial lung edema, including peribronchial fluid cuffs, subpleural edema, pleural effusions, and prominent septal lines. Notably, the interlobular septa were markedly thickened and nodular, with discrete, sometimes oval-shaped, small nodules (lymphatic pearls) distributed peripherally.
Key takeaways
Lymphatic pearls are nodular opacities seen in interstitial edema, representing distended septal lymphatics filled with edema fluid. This finding is a specific manifestation of interstitial lung edema and can be mistaken for other nodular processes. In the context of stem cell transplantation, it is likely related to fluid overload from treatment rather than infection.
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