Tree in bud sign

In radiology, the tree-in-bud sign is a finding on a CT scan that indicates some degree of airway obstruction.
The tree-in-bud sign indicates the presence of an infection that has spread endobronchially, and is classically associated with tuberculosis and bronchopneumonia.

Histopathologic studies have shown that the tree-in-bud pattern is caused by demarcation of the normally invisible branching course of the peripheral airways, which is usually results from bronchiolar impaction with mucus, pus, or fluid. In addition, dilated and thickened walls of the peripheral airways and peribronchitis can make the affected bronchioles more easily visible, as is seen in patients with cystic fibrosis.

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