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Interlobular Septal Thickening: A Pictorial Review.
Courtney E Walters1, Liane Ruddy2, Amar S Shah1
1Diagnostic Radiology Residency (Arizona), Mayo Clinic College of Medicine and Science, Scottsdale.
Journal of Computer Assisted Tomography
|June 4, 2026
Summary
Interlobular septal thickening (ILST) on chest CT indicates lung disease. This pictorial essay reviews common and rare causes of ILST, categorized by smooth, nodular, or irregular patterns, aiding diagnosis.
Area of Science:
- Radiology
- Pulmonary Medicine
- Pathology
Background:
- Interlobular septal thickening (ILST) is a computed tomography (CT) finding of abnormal widening of lung interlobular septa.
- Normally invisible on CT, ILST signifies underlying pulmonary pathology.
- ILST patterns include smooth, nodular, and irregular/fibrotic, each linked to distinct disease processes.
Purpose of the Study:
- To provide a comprehensive review of common and rare etiologies of ILST.
- To categorize ILST patterns and discuss their associated disease processes.
- To correlate ILST imaging features with clinical and pathological findings for diagnostic support.
Main Methods:
- Review of common and rare causes of ILST.
- Categorization of ILST into smooth, nodular, and irregular/fibrotic patterns.
- Presentation of ILST features, distribution, and ancillary imaging findings.
Main Results:
- Each ILST pattern is associated with specific, often distinct, disease etiologies.
- Detailed discussion of pathophysiology, epidemiology, risk factors, symptoms, and management for each disease.
- Integration of imaging findings, distribution, and clinical data to support diagnosis.
Conclusions:
- ILST patterns on chest CT are crucial indicators of various pulmonary diseases.
- Understanding ILST morphology and distribution aids in differentiating between pathologies.
- This review serves as a diagnostic guide for radiologists and clinicians encountering ILST.
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