The term “tree-in-bud” is used to describe processes affecting the small airways that result in centrilobular nodular and linear branching structures on high-resolution CT of the lungs. Many categories of disorders can result in the “tree-in-bud” pattern; the most common is infectious processes with endobronchial spread of disease. The common high-resolution CT features of all processes producing the “tree-in-bud” pattern are bronchiolar dilation and impaction of bronchioles with mucus, pus, or other material. The high-resolution CT findings are nonspecific, but a specific diagnosis can occasionally be suggested when the findings are correlated with patient history, clinical information, associated CT scan findings, and chronicity of disease.
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