Different sizes of centrilobular ground-glass opacities in chest high-resolution computed tomography of patients with pulmonary veno-occlusive disease and patients with pulmonary capillary hemangiomatosis

Cardiovasc Pathol. Jul-Aug 2013;22(4):287-93. doi: 10.1016/j.carpath.2012.12.002. Epub 2013 Jan 10.

Abstract

Background: Centrilobular ground-glass opacity (GGO) is one of the characteristic findings in chest high-resolution computed tomography (HRCT) of patients with pulmonary veno-occlusive disease (PVOD) and patients with pulmonary capillary hemangiomatosis (PCH). However, clinical differential diagnosis of these two diseases is difficult and has not been established. In order to clarify their differences, we compared the sizes of GGOs in chest HRCT and the sizes of capillary assemblies in pulmonary vascular casts between patients diagnosed pathologically with PVOD and PCH.

Methods: We evaluated chest HRCT images for four patients with idiopathic pulmonary arterial hypertension (IPAH), three patients with PVOD and three patients with PCH, and we evaluated pulmonary vascular casts of lung tissues obtained from those patients at lung transplantation or autopsy.

Results: Centrilobular GGOs in chest HRCT were observed in patients with PVOD and patients with PCH but not in patients with IPAH. We measured the longest diameter of the GGOs. The size of centrilobular GGOs was significantly larger in patients with PCH than in patients with PVOD (5.60±1.43 mm versus 2.51±0.79 mm, P<.01). We succeeded in visualization of the 3-dimensional structures of pulmonary capillary vessels obtained from the same patients with PVOD and PCH undergoing lung transplantation or autopsy and measured the diameters of capillary assemblies. The longest diameter of capillary assemblies was also significantly larger in patients with PCH than in patients with PVOD (5.44±1.71 mm versus 3.07±1.07 mm, P<.01).

Conclusion: Measurement of the sizes of centrilobular GGOs in HRCT is a simple and useful method for clinical differential diagnosis of PVOD and PCH.

Keywords: Centrilobular ground-glass opacity; Computed tomography; Pulmonary capillary hemangiomatosis; Pulmonary hypertension; Pulmonary veno-occlusive disease.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Autopsy
  • Capillaries / diagnostic imaging*
  • Capillaries / pathology
  • Child
  • Diagnosis, Differential
  • Familial Primary Pulmonary Hypertension
  • Female
  • Hemangioma, Capillary / diagnostic imaging*
  • Hemangioma, Capillary / pathology
  • Hemangioma, Capillary / surgery
  • Humans
  • Hypertension, Pulmonary / diagnostic imaging*
  • Hypertension, Pulmonary / pathology
  • Hypertension, Pulmonary / surgery
  • Imaging, Three-Dimensional
  • Lung / blood supply*
  • Lung / diagnostic imaging*
  • Lung / pathology
  • Lung / surgery
  • Lung Neoplasms / diagnostic imaging*
  • Lung Neoplasms / pathology
  • Lung Neoplasms / surgery
  • Lung Transplantation
  • Male
  • Predictive Value of Tests
  • Pulmonary Veno-Occlusive Disease / diagnostic imaging*
  • Pulmonary Veno-Occlusive Disease / pathology
  • Pulmonary Veno-Occlusive Disease / surgery
  • Radiographic Image Interpretation, Computer-Assisted
  • Replica Techniques
  • Respiratory Function Tests
  • Tomography, X-Ray Computed*
  • Young Adult