Question 1
What is the hallmark pathological feature of honeycomb lung?
- A. Dilated bronchi with mucus plugging
- B. Thickened alveolar septa with inflammatory infiltrates
- C. Cystic spaces lined by bronchiolar epithelium
- D. Cavitation with necrotic debris
Answer: C. Cystic spaces lined by bronchiolar epithelium
Explanation: The hallmark feature of honeycomb lung is the presence of cystic spaces lined by bronchiolar epithelium, reflecting end-stage fibrosis and parenchymal remodeling.
?Honeycombing is characterized by subpleural cystic spaces, which are lined by bronchiolar epithelium, representing chronic fibrotic changes.?
Reference: Fleischner Society Glossary (Fleischner Society).
Question 2
What is the typical size range of cystic spaces in honeycomb lung?
- A. 1?5 mm
- B. 10?20 mm
- C. >20 mm
- D. 3?10 mm
Answer: D. 3?10 mm
Explanation: Honeycomb cystic spaces are typically uniform in size, measuring 3?10 mm, although some may be slightly larger in advanced disease.
?Cystic spaces in honeycombing measure 3?10 mm and appear uniform in size, clustered in subpleural regions.?
Reference: Radiology Journal (Radiology).
Question 3
Which radiological finding helps distinguish honeycomb lung from traction bronchiolectasis?
- A. Cystic spaces clustered in layers without airway continuity
- B. Ground-glass opacities and air bronchograms
- C. Dilated airways with connection to the bronchial tree
- D. Nodular opacities in perilymphatic distribution
Answer: A. Cystic spaces clustered in layers without airway continuity
Explanation: Honeycombing appears as stacked cystic spaces that are isolated from the bronchial tree, whereas traction bronchiolectasis shows dilated airways with continuity to larger airways.
?Honeycombing forms subpleural cystic spaces that are disconnected from the bronchial tree, in contrast to traction bronchiolectasis.?
Reference: Radiographics (Radiographics).
Question 4
In which of the following diseases is honeycomb lung a classic feature?
- A. Sarcoidosis
- B. Acute respiratory distress syndrome (ARDS)
- C. Idiopathic pulmonary fibrosis (IPF)
- D. Pulmonary embolism (PE)
Answer: C. Idiopathic pulmonary fibrosis (IPF)
Explanation: Honeycomb lung is a hallmark finding in IPF, typically associated with the usual interstitial pneumonia (UIP) pattern.
?The UIP pattern, characteristic of IPF, includes honeycombing as a key feature of end-stage fibrosis.?
Reference: Fleischner Society Glossary (Fleischner Society).
Question 5
Where is honeycombing most commonly located within the lungs?
- A. Central regions
- B. Subpleural and basal regions
- C. Peribronchovascular areas
- D. Upper lobes
Answer: B. Subpleural and basal regions
Explanation: Honeycombing is most commonly seen in the subpleural and basal regions of the lungs, reflecting the distribution of end-stage fibrosis.
?Honeycombing typically involves the subpleural and basal regions, consistent with advanced interstitial lung disease.?
Reference: Radiopaedia (Radiopaedia).
Question 6
How many layers of cystic spaces are typically seen in honeycombing?
- A. Single layer only
- B. Variable without pattern
- C. 2?3 layers
- D. >5 layers
Answer: C. 2?3 layers
Explanation: Honeycombing typically presents as 2?3 stacked layers of cystic spaces, though single-layer honeycombing may be seen in early stages.
?Honeycombing commonly involves 2?3 stacked layers of cystic spaces in the subpleural regions.?
Reference: Radiology Journal (Radiology).
Question 7
What distinguishes honeycombing from emphysematous bullae on imaging?
- A. Peripheral distribution of emphysematous bullae
- B. Connection to the airways
- C. Uniform size and clustered appearance in honeycombing
- D. Presence of ground-glass opacities in emphysema
Answer: C. Uniform size and clustered appearance in honeycombing
Explanation: Honeycombing is characterized by uniform cystic spaces clustered in subpleural regions, whereas emphysematous bullae are variable in size and lack a specific distribution.
?Honeycombing involves uniform cystic spaces clustered in subpleural regions, distinguishing it from emphysematous bullae.?
Reference: Radiopaedia (Radiopaedia).
Question 8
Which of the following is a key management strategy for honeycomb lung in IPF?
- A. Antibiotics targeting infection
- B. Bronchodilator therapy
- C. Antifibrotic therapy (e.g., nintedanib, pirfenidone)
- D. Corticosteroids alone
Answer: C. Antifibrotic therapy (e.g., nintedanib, pirfenidone)
Explanation: Antifibrotic therapy is the cornerstone of managing IPF with honeycombing, aimed at slowing disease progression.
?Nintedanib and pirfenidone are antifibrotic agents used to slow the progression of IPF and associated honeycombing.?
Reference: ATS Guidelines (American Thoracic Society).
Question 9
Which pulmonary function test (PFT) abnormality is most indicative of honeycomb lung?
- A. Increased residual volume (RV)
- B. Normal diffusion capacity (DLCO)
- C. Restrictive pattern with decreased total lung capacity (TLC)
- D. Obstructive pattern with increased FEV1/FVC
Answer: C. Restrictive pattern with decreased total lung capacity (TLC)
Explanation: Honeycomb lung is associated with a restrictive defect, characterized by reduced TLC and markedly reduced DLCO.
?Restrictive lung function with decreased TLC is characteristic of honeycomb lung in interstitial lung disease.?
Reference: AJR (American Journal of Roentgenology).
Question 10
Which imaging finding suggests advanced honeycomb lung?
- A. Peribronchovascular nodules
- B. Cavitation with air-fluid levels
- C. Ground-glass opacities with septal thickening
- D. Cystic spaces with traction bronchiectasis and reticulations
Answer: D. Cystic spaces with traction bronchiectasis and reticulations
Explanation: Advanced honeycomb lung is characterized by subpleural cystic spaces, traction bronchiectasis, and reticulations, indicative of end-stage fibrosis.
?Subpleural cystic spaces with traction bronchiectasis and reticular changes are hallmarks of advanced honeycomb lung.?
Reference: Radiographics (Radiographics).