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Pulmonary Hypertension: CT of the Chest in Pulmonary Venoocclusive Disease

Arnaud Resten1, Sophie Maitre1, Marc Humbert2, Anne Rabiller2, Olivier Sitbon2, Frédérique Capron3, Gérald Simonneau2 and Dominique Musset1

1 Service de Radiologie, UPRES EA 2705 (Maladies Vasculaires Pulmonaires), Hôpital Antoine Béclère, Assistance Publique–Hôpitaux de Paris, Université Paris–Sud, 157 rue de la Porte de Trivaux, Clamart 92140, France.
2 Service de Pneumologie et Réanimation Respiratoire, Hôpital Antoine Béclère, Clamart 92140, France.
3 Service d'Anatomie Pathologique, Hôpital Antoine Béclère, Clamart 92140, France.



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  		Fig. 1A. —Medium-power photomicrographs of histopathologic specimens of pulmonary venoocclusive disease and primary pulmonary hypertension. (H and E) Specimen of pulmonary venoocclusive disease shows obliterated vein longitudinally (arrowhead). Brown granular hemosiderin (arrow) is also present.

 


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  		Fig. 1B. —Medium-power photomicrographs of histopathologic specimens of pulmonary venoocclusive disease and primary pulmonary hypertension. (H and E) Specimen of primary pulmonary hypertension displays plexiform lesion (arrow) characterized by intimal proliferation and interruption of media by glomeruloid proliferation of small vascular channels.

 


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  		Fig. 2. —Transverse high-resolution CT scan obtained in 41-year-old woman with severe pulmonary hypertension shows ground-glass opacity with centrilobular pattern and poorly defined nodular opacities with diameters ranging from only a few millimeters to 1 cm. Nodules have random distribution. At postmortem examination, pulmonary venoocclusive disease was diagnosed.

 


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  		Fig. 3. —High-resolution CT scan obtained in 32-year-old man with severe pulmonary hypertension shows central panlobular distribution of ground-glass opacities (stars) with relatively well-defined borders, mimicking chronic postembolic disease. At postmortem examination, primary pulmonary hypertension was diagnosed.

 


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  		Fig. 4. —Transverse high-resolution CT scan obtained in 23-year-old woman with severe pulmonary hypertension reveals septal lines, thickened interlobular septa (polygonal pattern) (arrowheads) with basal predominance. Poorly defined centrilobular nodular opacities are also noted. At postmortem examination, pulmonary venoocclusive disease was diagnosed.

 

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