I often see in the X-ray chest examination report, “Increased and thickened texture in both lungs, please combine with clinical.” , what does this mean? To understand the true meaning of such reports, we must first talk about the composition of the lung textures. The pulmonary arteries, pulmonary veins, bronchial and lymphatic structures in the lungs are equivalent to the branches of the tree, which are radiographically distributed from the pulmonary hilum to the lung field in a dendritic pattern, which we call “pulmonary texture”. Therefore, lung texture is the shadow of blood vessels and airways in the lungs. In which cases does the lung texture increase and thicken? Under normal circumstances, the lung texture may increase and thicken in young and strong people with high blood pressure, on hot days, after strenuous exercise, in long-term smokers, and in women during their menstruation and maternity. In pathological conditions, such as fever, early pneumonia, long-term cough, acute and chronic bronchitis, certain heart diseases or late stages of heart disease (pulmonary congestion, pulmonary stasis, pulmonary edema, cardiac insufficiency), lymphatic diseases, occupational diseases, etc., will definitely show increased lung texture thickening. Certain equipment factors, such as photographs or images obtained under different equipment conditions, may produce different effects on lung texture; the same patient may also produce different effects on lung texture under different equipment conditions. For example, the effect of ordinary photography and digital photography is very different, the latter can show the lung texture structure more because of high resolution; in subjective judgment, different radiologists’ experience, level and experience will have different judgment standards; objectively, the reading conditions of different workplaces and the advantages and disadvantages of monitors affect the judgment effect. Finally, in order to reach a tacit agreement with the clinician, some descriptive diagnosis has to be made to eliminate the patient’s psychological pressure. Therefore, there is no objective, quantifiable standard for the significance of increased lung texture, and it is related to the health status of the subject, equipment factors, and the personal experience of the diagnosing physician. There are many causes of increased lung texture, which can be either pathological, physiological or technical. In general, reporting increased lung texture in isolation is of little value for clinical reference. Only by carefully analyzing the nature of increased pulmonary texture and combining it with other X-ray manifestations and clinical conditions and technical conditions can a correct conclusion be drawn. That is, increased lung texture without any clinical symptoms may well be physiological, i.e., completely normal.