Honeycombing in HRCT

Honeycombing is defined by the presence of small air containing cystic spaces generally lined by bronchiolar epithelium and having thick walls composed of dense fibrous tissue.

Indicates presence of end stage lung disease 

Characteristics of honeycomb cysts:

Thick walled

Air filled(black)

3-10mm in diameter 

Immediately subpleural in location 

Occur in clusters or layers and share walls

Non branching

Associated with other findings of fibrosis (traction bronchiectasis, irregular reticulation, volume loss and lung distortion)

Referrence- HRCT OF LUNG BY WEBB pg no-82(5th edition)

Role of aminophylline in asthma

 Aminophylline - It is a phosphodiesterase inhibitor used as an adjunct bronchodilator treatment.

Aminophylline predominantly inhibits PDE3 in airway smooth muscles which increases intracellular cyclic AMP leading to bronchodilator effect.

Also has anti-inflammatory properties.

Therapeutic range of 10 -20 mg/l.

Due to narrow therapeutic index and adverse effect profile, along with availability of more effective alternatives, it is now infrequently used in patients with asthma.

Acute exacerbation of IPF

 A previous or concurrent diagnosis of IPF

with 

1.acute worsening or development of dyspnea of typically less than 1 month(clinically)

2.new bilateral ground glass opacity or consolidation superimposed on a background consistent with UIP pattern 

3.Deterioration not fully explained by cardiac failure or fluid overload or infection.