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Overview of the Anatomy of the Lungs Large Airways and Small Airways
This image shows the division of the airways in the lungs classified as large airways and small airways.
A large airway is considered any airway larger than 2mm, and therefore includes all the airways involved with transport of air except for the terminal bronchiole. Included as seen in image a, are the trachea, mainstem bronchi, lobar bronchi segmental and subsegmental airways and the 3 subsequent divisions of subsegmental bronchi and bronchioles till the last transporting airway ? the respiratory bronchiole which is usually about 2mm and is considered a small airway Image (a) shows the airways starting in the trachea and continuing to the mainstem bronchi, lobar bronchi, segmental bronchi, and subsegmental bronchi.
Image b shows the structures that make up the small airways starting with the terminal bronchiole (tb) followed by the respiratory bronchiole (rb) alveolar duct, (ad) and alveolar sacs (as)
Image (c) shows the histologic makeup of the large airways that include a pseudostratified ciliated columnar epithelium with mucus secreting goblet cells a muscular layer (red) and a prominent cartilage layer (white) In the larger bronchioles (d) the epithelium remains as a pseudostratified, ciliated, columnar epithelium with prominent muscular layer (red).  The columnar epithelium transitions to a stratified ciliated cuboidal epithelium by the terminal bronchiole s (f) both still with a muscular layer.  The respiratory epithelium transitions from a cuboidal epithelium to a squamous epithelium (f)  with alveoli and type I and II pneumocytes starting to branch (g) 
Ashley Davidoff MD TheCommonVein.net lungs-0740nL
Keywords
lungs airways segmental subsegmental small airway disease micronodules
Ashley Davidoff MD
TheCommonVein.net
Segmental and Subsegmental airway disease with Wall Thickening
Ashley Davidoff MD
TheCommonVein.net

CHF

50 year old female with diabetes, chronic renal failure with congestive heart failure.  CT in the coronal plane shows diffuse ground glass changes, Kerley B lines  peribronchial cuffing in the right upper lobe and right lower lobe
Ashley Davidoff MD TheCommonvein.net  50-004-CT
50 year old female with diabetes, chronic renal failure with congestive heart failure.  CT in the coronal plane shows diffuse ground glass changes, peribronchial cuffing and mosaic attenuation
Ashley Davidoff MD TheCommonvein.net  50-005-CT
50 year old female with diabetes, chronic renal failure with congestive heart failure.  CT in the axial  plane shows diffuse ground glass changes, mild mosaic attenuation changes bilaterally, and a complex right effusion
Ashley Davidoff MD TheCommonvein.net  50-009-CT
50 year old female with diabetes, chronic renal failure with congestive heart failure.  CT in the axial plane shows diffuse ground glass changes, thickening of the interlobular septa,  centrilobular nodules  peribronchial cuffing  mosaic attenuation in the  right lower lobe, associated with a complex right sided effusion
Ashley Davidoff MD TheCommonvein.net  50-010-CT

Chemotherapy

CT post chemo shows left lower lobe subsegmental infiltrate, ground glass pattern and thickening of the subsegmental airways in the lower lobes
thecommonvein.net
Ashley Davidoff MD

 

Amyloidosis

Amyloid Involving the Airways
Axial CT image shows involvement of known amyloid in the trachea (a,b,c,d) as well as the segmental and subsegmental airways (d,e,f)
Ashley Davidoff MD
TheCommonVein.net amyloid-airways-001b
Amyloid in the Segmental and Subsegmental Airways
Ashley Davidoff
TheCommonVein.net 44f Amyloid airways 004

Miliary TB

Micronodules Right Upper Lobe Thickening of the Bronchioles
68 year old female presented with malaise night sweats weight loss QuantiFeron gold positive, with a past history of treated TB in her native country as a child.  Axial CT images through the upper lobe shows a miliary pattern of disease affecting interlobular septa along the venules , centrilobular and tree in bud nodular patterns.  Bronchoscopy isolated Mycobacterium complex.  She was treated with good result
Ashley Davidoff MD TheCommonVein.net mycobacterium-complex-TB-68-004
Micronodules Right Upper Lobe Thickening of the Bronchioles
68 year old female presented with malaise night sweats weight loss QuantiFeron gold positive, with a past history of treated TB in her native country as a child.  Axial CT images through the upper lobe shows a miliary pattern of disease affecting interlobular septa along the venules , centrilobular and tree in bud nodular patterns.  Bronchoscopy isolated Mycobacterium complex.  She was treated with good result
Ashley Davidoff MD TheCommonVein.net mycobacterium-complex-TB-68-005

Aspergillosis

Bronchopneumonic Form of Aspergillosis
43 year old man with known aspergillus infection. Note the thickening of the walls of the segmental subsegmental and small airways with extensive tree in bud changes and bronchial wall thickening. There are centrilobular nodules indicating the small airway disease
Ashley Davidoff MD TheCommonVein.net
117816c
CVID small airway disease with segmental and subsegmental wall thickening
Ashley Davidoff MD TheCommonvein.net CVID small airway disease 006

 

Metastatic Breast Carcinoma

Tumor emboli from breast carcinoma in a 52-year-old woman. High-resolution CT scans show enlarged and beaded subsegmental arteries in the lower lobes. Note the peripheral tree-in-bud opacities.
Rossi, SE et al Tree-in-Bud Pattern at Thin-Section CT of the Lungs: Radiologic-Pathologic Overview RadioGraphicsVol. 25, No. 3 2005

Eosinophillic Pneumonia

CT scan shows bilateral subsegmental infiltrates both along the bronchovascular bundle as well s peripherally in the lower lobes, lingula and middle lobe. The upper lobes are involved to lesser degree
Ashley Davidoff MD
TheCommonVein.net

Asbestosis

72 year old man with asbestosis. Chest Xray (a) shows diffuse reticular changes, dominant in the lower lobes and with a “shaggy” heart border, implying involvement of the middle lobe and lingular segments. Image b is an axial slice at the level of the main pulmonary artery and shows calcified pleural plaques in the posteromedial and right anteromedial locations. Image c of the upper lung zones show mild reticular changes and honeycomb changes. Image d shows reticular changes, more dense fibrotic changes in the lingula, thickening along right lower lobe subsegmental airway and early honeycombing
Ashley Davidoff MD thecommonvein.net 47060c01
keywords chest lung fx shaggy heart border reticular changes interstitial lung disease interstitium honeycombing pleural calcification fibrosis dx asbestosis