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Kerley B (septal) lines

Case contributed by Stefan Tigges
Diagnosis almost certain

Presentation

Shortness of breath.

Patient Data

Age: 60 years.
Gender: Male
x-ray

Kerley B lines, otherwise normal.

ct
  • Thickened interlobular septa
  • thickened peribronchial interstitium
  • thickened fissures compatible with subpleural edema and/or interlobar effusions
  • trace dependent pleural effusions
  • ground-glass opacity influenced by gravity with increased opacity in the dependent portion of the secondary lobules and the lobes of the lung,
  • normal heart chambers, major arteries, systemic veins

Case Discussion

The septal lines and ground-glass opacity are most suggestive of pulmonary edema. Be sure to look at the PA chest X-ray and the coronal CT images to better appreciate the appearance of Kerley B lines. 

Normal heart size is compatible with pulmonary edema. Diastolic dysfunction and non-cardiogenic pulmonary edema are examples of this.

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