{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T10:06:54Z","timestamp":1778839614069,"version":"3.51.4"},"reference-count":31,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T00:00:00Z","timestamp":1778716800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Objective: In this study, we aimed to evaluate high-resolution computed tomography (HRCT) features of granulomatous\u2013lymphocytic interstitial lung disease (GLILD) in patients with Common Variable Immunodeficiency (CVID), and to describe a novel imaging feature\u2014termed the \u201cKebab sign\u201d\u2014as a potential radiologic marker of GLILD. Materials and Methods: We retrospectively reviewed HRCT scans of 15 patients with GLILD diagnosed between 2005 and 2025 at a single institution (seven biopsy-confirmed, eight probable diagnoses based on multidisciplinary consensus). CT patterns were assessed for predominant morphology (nodular, reticular, alveolar, fibrotic), distribution (axial and cranio-caudal), and presence of extra-parenchymal findings. Nodules were characterized by size, density, morphology, and the presence of air bronchograms. The \u201cKebab sign\u201d was defined as nodules aligned along bronchial structures with associated peribronchial thickening. Results: All patients demonstrated a diffuse nodular pattern, with non-calcified macronodules in 100% and micronodules in 60% of cases. Air bronchograms were present in 87% of macronodules. A peri-bronchovascular distribution with lower lung predominance was observed in the majority of cases. The \u201cKebab sign\u201d was identified in 87% of patients. Splenomegaly and hilar\/mediastinal lymphadenopathy were observed in 75%. In 20% of patients, fibrosing features were also present, particularly in older individuals. Conclusions: HRCT findings of GLILD typically include peri-bronchovascular nodules with lower lobe predominance, typically associated with splenomegaly and mediastinal lymphadenopathy. The newly described \u201cKebab sign,\u201d reflecting nodular alignment along thickened bronchial structures, may represent a useful imaging clue to support the diagnosis of GLILD.<\/jats:p>","DOI":"10.3390\/diagnostics16101496","type":"journal-article","created":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T13:04:09Z","timestamp":1778763849000},"page":"1496","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["CT Features of Granulomatous\u2013Lymphocytic Interstitial Lung Disease (GLILD): The \u201cKebab Sign\u201d as a Marker to Support Differential Diagnosis"],"prefix":"10.3390","volume":"16","author":[{"given":"Federica","family":"Ciccarese","sequence":"first","affiliation":[{"name":"Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicol\u00f2","family":"Piva","sequence":"additional","affiliation":[{"name":"Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-8183-1323","authenticated-orcid":false,"given":"Marco","family":"Carpano","sequence":"additional","affiliation":[{"name":"Respiratory and Critical Care Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-4849-2747","authenticated-orcid":false,"given":"Ilaria","family":"Bassi","sequence":"additional","affiliation":[{"name":"Respiratory and Critical Care Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aldo","family":"Guerrieri","sequence":"additional","affiliation":[{"name":"Respiratory and Critical Care Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gioacchino","family":"Schifino","sequence":"additional","affiliation":[{"name":"Respiratory Medicine Unit, Department od Cardio-Thoracic-Vascular Pathologies, Arcispedale Sant\u2019Anna, Via A. Moro 8, 44124 Ferrara, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefano","family":"Nava","sequence":"additional","affiliation":[{"name":"Respiratory and Critical Care Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy"},{"name":"Alma Mater Studiorum, Department of Medical and Surgical Sciences (DIMEC), University of Bologna, 40138 Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristina","family":"Mosconi","sequence":"additional","affiliation":[{"name":"Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy"},{"name":"Alma Mater Studiorum, Department of Medical and Surgical Sciences (DIMEC), University of Bologna, 40138 Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maurizio","family":"Zompatori","sequence":"additional","affiliation":[{"name":"Alma Mater Studiorum, Department of Medical and Surgical Sciences (DIMEC), University of Bologna, 40138 Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"102749","DOI":"10.1016\/j.eclinm.2024.102749","article-title":"Approach to diagnosing and managing granulomatous-lymphocytic interstitial lung disease","volume":"75","author":"Catanzaro","year":"2024","journal-title":"eClinicalMedicine"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1016\/j.mcna.2023.06.012","article-title":"Common Variable Immunodeficiency","volume":"108","author":"Remiker","year":"2024","journal-title":"Med. 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