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Tree-in-bud pattern at thin-section CT of the lungs: radiologic-pathologic overview
Santiago Enrique Rossi1, Tomas Franquet, Mariano Volpacchio
1Department of Radiology, Centro de Diagnostico Dr Enrique Rossi, Arenales 2777, CP 1425, Buenos Aires, Argentina. santirossi@cdrossi.com
Summary
The tree-in-bud pattern on lung CT scans indicates various conditions, not just tuberculosis. Recognizing these diverse causes aids in accurate diagnosis and prevents medical errors.
Area of Science:
- Radiology
- Pulmonology
- Pathology
Background:
- The tree-in-bud pattern is a recognized finding on thin-section computed tomography (CT) of the lungs.
- This pattern is characterized by centrilobular nodules connected to branching linear structures from a single stalk.
- Initially associated with Mycobacterium tuberculosis, its differential diagnosis is now known to be much broader.
Purpose of the Study:
- To review the diverse causes of the tree-in-bud pattern observed in lung CT.
- To highlight the importance of considering multiple etiologies beyond infection.
- To emphasize the role of clinical correlation in diagnosing the underlying cause.
Main Methods:
- Review of relevant medical literature and imaging findings.
- Analysis of CT characteristics of the tree-in-bud pattern.
- Correlation of imaging findings with clinical presentations and diagnoses.
Main Results:
- The tree-in-bud pattern is associated with a wide spectrum of diseases.
- These include peripheral airway diseases (infections, congenital, idiopathic, aspiration, immunologic, connective tissue disorders) and pulmonary vascular diseases.
- Radiologic findings alone may not differentiate causes, necessitating clinical information.
Conclusions:
- The tree-in-bud pattern on CT is a manifestation of numerous conditions affecting the lungs.
- Accurate diagnosis requires integrating imaging findings with patient history and clinical presentation.
- Awareness of the differential diagnoses is crucial for avoiding diagnostic errors.