Question 1
Which of the following is the most common cause of smooth interlobular septal thickening?
Options:
A. Sarcoidosis
B. Pulmonary venous congestion
C. Amyloidosis
D. Lymphangitic carcinomatosis
Correct Answer:
B. Pulmonary venous congestion
Explanation:
Smooth interlobular septal thickening is most commonly caused by pulmonary venous congestion due to left heart failure, where increased hydrostatic pressure leads to fluid accumulation.
Reference:
- Radiopaedia: Interlobular Septal Thickening
“The most common causes of interlobular septal thickening include pulmonary edema (smooth), lymphangitic carcinomatosis (nodular), and fibrosis (irregular).”
Question 2
Which systemic disease is associated with nodular interlobular septal thickening due to granulomatous inflammation?
Options:
A. Sarcoidosis
B. Pulmonary edema
C. Amyloidosis
D. Tuberculosis
Correct Answer:
A. Sarcoidosis
Explanation:
Sarcoidosis, a granulomatous disease, can cause nodular interlobular septal thickening due to lymphatic involvement, typically affecting the upper lobes.
Reference:
- Radiopaedia: Sarcoidosis Overview
“Sarcoidosis typically manifests as nodular thickening of interlobular septa due to granulomatous inflammation.”
Question 3
Which of the following diseases is associated with interlobular septal thickening and calcifications?
Options:
A. Sarcoidosis
B. Silicosis
C. Amyloidosis
D. All of the above
Correct Answer:
D. All of the above
Explanation:
Calcified interlobular septa can be seen in sarcoidosis, silicosis, and amyloidosis. Sarcoidosis causes calcification due to chronic granulomatous inflammation, while silicosis and amyloidosis can result in septal calcifications due to metabolic or environmental exposure.
Reference:
- Radiopaedia: Sarcoidosis Overview
“Calcification of lymph nodes and interlobular septa is a feature seen in chronic sarcoidosis.” - Radiopaedia: Silicosis Overview
“Silicosis may result in septal thickening, often associated with calcification.”
Question 4
Which condition is the classic cause of the crazy paving pattern on CT?
Options:
A. Sarcoidosis
B. Pulmonary alveolar proteinosis
C. Amyloidosis
D. Pneumocystis pneumonia
Correct Answer:
B. Pulmonary alveolar proteinosis
Explanation:
Pulmonary alveolar proteinosis is the classic cause of crazy paving, a pattern of thickened interlobular septa superimposed on ground-glass opacities, due to surfactant accumulation.
Reference:
- Radiopaedia: Crazy Paving Pattern
“Crazy paving is a classic finding in pulmonary alveolar proteinosis, caused by surfactant accumulation.”
Question 5
Which of the following is associated with smooth interlobular septal thickening and ground-glass opacities?
Options:
A. Pulmonary edema
B. Amyloidosis
C. Hypersensitivity pneumonitis
D. All of the above
Correct Answer:
D. All of the above
Explanation:
Smooth interlobular septal thickening and ground-glass opacities are nonspecific findings that can be seen in pulmonary edema, amyloidosis, and hypersensitivity pneumonitis.
Reference:
- Fleischner Glossary: Imaging of the Pulmonary Interstitium
“Interlobular septal thickening is a nonspecific finding seen in pulmonary edema, fibrosis, and infiltrative diseases like amyloidosis.”
Question 6
Amyloidosis is associated with which of the following patterns of interlobular septal thickening?
Options:
A. Smooth thickening
B. Nodular thickening
C. Calcified thickening
D. All of the above
Correct Answer:
D. All of the above
Explanation:
Amyloidosis can cause smooth, nodular, or calcified interlobular septal thickening, depending on the stage and distribution of amyloid deposition.
Reference:
- Radiopaedia: Pulmonary Amyloidosis
“Pulmonary amyloidosis may manifest with smooth, nodular, or calcified interlobular septal thickening.”
Question 7
Which imaging modality is most sensitive for identifying interlobular septal thickening?
Options:
A. Chest X-ray
B. CT scan
C. MRI
D. PET-CT
Correct Answer:
B. CT scan
Explanation:
CT is the gold standard for evaluating interlobular septal thickening, offering detailed characterization of smooth, nodular, or calcified patterns.
Reference:
- Radiopaedia: Interlobular Septal Thickening
“CT is the most sensitive modality for identifying and characterizing interlobular septal thickening.”
Question 8
Which of the following systemic diseases is associated with interlobular septal thickening due to extracellular protein deposition?
Options:
A. Sarcoidosis
B. Amyloidosis
C. Tuberculosis
D. Hypersensitivity pneumonitis
Correct Answer:
B. Amyloidosis
Explanation:
Amyloidosis results in interlobular septal thickening due to extracellular deposition of amyloid proteins, which may be smooth, nodular, or calcified.
Reference:
- Radiopaedia: Pulmonary Amyloidosis
“Amyloid deposition within the lung parenchyma can lead to interlobular septal thickening.”
Question 9
Which of the following conditions is associated with nodular and upper lobe-predominant interlobular septal thickening?
Options:
A. Sarcoidosis
B. Pulmonary edema
C. Lymphangitic carcinomatosis
D. Alveolar proteinosis
Correct Answer:
A. Sarcoidosis
Explanation:
Sarcoidosis frequently causes nodular interlobular septal thickening with an upper lobe predominance due to granulomatous inflammation along lymphatic pathways.
Reference:
- Radiopaedia: Sarcoidosis Overview
“Nodular interlobular septal thickening with an upper lobe predominance is a classic finding in sarcoidosis.”
Question 10
Which systemic disease may cause interlobular septal thickening with a crazy paving pattern due to both protein deposition and ground-glass opacity?
Options:
A. Pulmonary amyloidosis
B. Pulmonary alveolar proteinosis
C. Sarcoidosis
D. All of the above
Correct Answer:
D. All of the above
Explanation:
All these conditions can present with a crazy paving pattern, though pulmonary alveolar proteinosis is the prototypical cause. Amyloidosis and sarcoidosis may also present with mixed patterns due to protein deposition and alveolar involvement.
Reference:
- Radiopaedia: Crazy Paving Pattern
“Crazy paving describes a pattern of interlobular septal thickening with superimposed ground-glass opacity.”