Home | About us | Editorial Board | Search | Ahead of print | Current Issue | Archives | Instructions | Online submissionContact Us   |  Subscribe   |  Advertise   |  Login  Page layout
Wide layoutNarrow layoutFull screen layout
Lung India Official publication of Indian Chest Society  
  Users Online: 188   Home Print this page  Email this page Small font size Default font size Increase font size


 
  Table of Contents    
LETTER TO EDITOR
Year : 2016  |  Volume : 33  |  Issue : 1  |  Page : 113  

Pipe-cleaner sign


1 Department of Radiology, Institute of Liver and Biliary Sciences, New Delhi, India
2 Department of Oncology, Institute of Liver and Biliary Sciences, New Delhi, India
3 Department of Pulmonary Medicine, Institute of Liver and Biliary Sciences, New Delhi, India

Date of Web Publication4-Jan-2016

Correspondence Address:
Binit Sureka
Department of Radiology, Institute of Liver and Biliary Sciences, New Delhi
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0970-2113.173071

Rights and Permissions

How to cite this article:
Sureka B, Bansal K, Panda D, Mariotta S. Pipe-cleaner sign. Lung India 2016;33:113

How to cite this URL:
Sureka B, Bansal K, Panda D, Mariotta S. Pipe-cleaner sign. Lung India [serial online] 2016 [cited 2019 Jun 16];33:113. Available from: http://www.lungindia.com/text.asp?2016/33/1/113/173071

Sir,

We would like to highlight an important forgotten sign on chest computed tomography (CT) known as the “pipe-cleaner” sign. This sign is diagnostic of pulmonary sarcoidosis in a given clinical context.[1] The sign is seen due to pulmonary nodules within the bronchovascular lymphatics, also known as perilymphatic nodules. The nodules in the perilymphatic distribution result in nodular bronchovascular interstitial thickening. When this thickening is seen along the major fissures, it resembles a pipe-cleaner. A pipe-cleaner is a type of brush originally intended for removing moisture and residue from smoking pipes [Figure 1] and [Figure 2].
Figure 1: Illustration of a pipe-cleaner used to clean smoking pipe

Click here to view
Figure 2: (a) Chest radiograph showing nodular thickening of the right fissure (arrow) with ill-.defined nodules in the right lower zone and tenting of the right diaphragm. (b) Axial chest CT scan showing nodular fissural thickening (arrowhead) resembling a pipe-cleaner. In addition, a few perilymphatic and centrilobular nodules are seen in the bilateral lungs

Click here to view


Perilymphatic nodules are nodules along the lymphatics and are seen along the pleural surface, large vessels and bronchi, interlobular septa, and centrilobular regions and are usually less than 5 mm in size. Diagnostic differentials for perilymphatic distribution of nodules on chest CT are sarcoidosis, lymphangitic carcinomatosis, silicosis, coal worker's pneumoconiosis, lymphoma, lymphoid interstitial pneumonia, and rarely amyloidosis.[2]

We wish to emphasize that both clinicians and radiologists who are regularly seeing and interpreting chest CT scans should be aware of this sign.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
   References Top

1.
Shroff G, Konopka K, Chiles C. Perilymphatic Pulmonary Nodules: Definition, Differential Diagnosis, and Demonstration of the “Pipe-Cleaner” Sign. Contemp Diagn Radiol 2013;36:1-5.  Back to cited text no. 1
    
2.
Dähnert W. Chest. In: Dähnert W, editor. Radiology Review Manual. 7th ed. Philadelphia, PA: Lippincott Williams and Wilkins; 2011. p. 541.  Back to cited text no. 2
    


    Figures

  [Figure 1], [Figure 2]



 

Top
  
 
  Search
 
  
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
    Access Statistics
    Email Alert *
    Add to My List *
* Registration required (free)  

 
  In this article
    References
    Article Figures

 Article Access Statistics
    Viewed850    
    Printed3    
    Emailed0    
    PDF Downloaded181    
    Comments [Add]    

Recommend this journal