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Diseases affecting the peribronchovascular interstitium: CT findings and pathologic correlation
Eva Castañer1, Xavier Gallardo, Yolanda Pallardó
1Department of Radiolology, SDI UDIAT-CD, Institut Universitari Parc Taulí-UAB, Barcelona, Spain. ecastaner@cspt.es
Current Problems in Diagnostic Radiology
|March 9, 2005
Summary
Thickening of the peribronchovascular interstitium on CT scans indicates various diseases. Analyzing CT findings alongside clinical context aids in accurate diagnosis of these conditions.
Area of Science:
- Radiology
- Pathology
- Pulmonary Medicine
Background:
- The peribronchovascular interstitium, a connective tissue sheath surrounding central bronchi and pulmonary arteries, can thicken in numerous diseases.
- CT imaging reveals smooth, nodular, or irregular thickening, depending on the etiology.
- Diseases affecting this region often involve lymphatic routes or present with non-lymphatic distributions.
Purpose of the Study:
- To correlate CT findings with pathologic findings in disorders primarily affecting the peribronchovascular interstitium.
- To demonstrate how CT can help differentiate between various conditions causing peribronchovascular interstitial thickening.
- To highlight the importance of clinical context in diagnosing these pulmonary abnormalities.
Main Methods:
- Review of CT imaging findings in patients with peribronchovascular interstitial abnormalities.
- Correlation of imaging findings with histopathologic diagnoses.
- Illustration of characteristic CT appearances for a range of diseases affecting the peribronchovascular interstitium.
Main Results:
- Thickening of the peribronchovascular interstitium is a common finding in diverse pulmonary diseases.
- Specific CT patterns (smooth, nodular, irregular) can suggest underlying causes.
- Diseases with perilymphatic distribution (e.g., sarcoidosis, lymphangitic carcinomatosis) and those without (e.g., pulmonary edema, organizing pneumonia) show distinct or overlapping features.
- CT findings, when focused on the peribronchovascular region, significantly narrow the differential diagnosis.
Conclusions:
- CT is a valuable tool for evaluating diseases affecting the peribronchovascular interstitium.
- Integration of CT findings with clinical information is crucial for accurate diagnosis.
- Understanding the patterns of peribronchovascular interstitial thickening aids in differentiating between various pulmonary pathologies.
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