Distinguishing Honeycombing and Paraseptal Emphysema

Distinguishing between honeycombing and paraseptal emphysema may be difficult, especially when coexisting on a single scan. As compared with honeycombing, which may present as multiple layers of cysts stacked upon one another, emphysema presents as a single layer of holes without stacking.7 Furthermore, emphysematous holes are typically not hexagonal; therefore, the shape of the cysts and their propensity to stack can help to distinguish one from the other.7