Tree-in-bud pattern in central lung cancer: CT findings and pathologic correlation

Area of Science:

• Radiology
• Pulmonology
• Oncology

Background:

• The tree-in-bud (TIB) pattern is an imaging finding observed on chest CT scans.
• Its association with central lung cancer, particularly squamous cell carcinoma, requires further elucidation.
• Understanding the TIB pattern's incidence and characteristics is crucial for accurate diagnosis.

Purpose of the Study:

• To determine the incidence of the TIB pattern in patients with central lung cancer.
• To describe the characteristic CT findings associated with the TIB pattern.
• To correlate the imaging findings with the pathological basis of the TIB pattern.

Main Methods:

• Retrospective analysis of 652 consecutive patients with confirmed central lung cancer.
• Evaluation of CT scans for the presence and characteristics of the TIB pattern.
• Correlation of CT findings with pathological data.

Main Results:

• The TIB pattern was identified in 22.5% of patients with central lung cancer.
• TIB pattern was significantly more frequent in squamous cell carcinoma compared to non-squamous cell carcinoma.
• Key CT findings included obstructive bronchial mucoid impaction, consolidation, and ground-glass opacities, predominantly in a focal distribution.

Conclusions:

• The TIB pattern is a common finding in central lung squamous cell carcinoma on CT scans.
• Obstructive bronchial mucoid impaction is the most significant associated CT finding.
• Pathologically, the TIB pattern represents mucoid impaction of bronchioles and bronchiolitis, aiding in the interpretation of central lung cancer imaging.