Diagnostics (Dec 2021)

Pulmonary Vasculitides: A Radiological Review Emphasizing Parenchymal HRCT Features

  • Stefano Palmucci,
  • Corrado Inì,
  • Salvatore Cosentino,
  • Luigi Fanzone,
  • Stefano Di Pietro,
  • Alessia Di Mari,
  • Federica Galioto,
  • Francesco Tiralongo,
  • Giovanna Vignigni,
  • Stefano Toscano,
  • Gianluca Sambataro,
  • Carlo Vancheri,
  • Giulio Distefano,
  • Antonio Basile

DOI
https://doi.org/10.3390/diagnostics11122318
Journal volume & issue
Vol. 11, no. 12
p. 2318

Abstract

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Vasculitides represent a heterogeneous group of immune-mediated disorders, characterized by a systemic inflammatory destructive process of the blood vessels resulting either in ischemia or hemorrhage. The organ involved and vessel size influence the pattern of presentation of the pathology. The lung is commonly involved in systemic vasculitides, with heterogeneous clinical, radiological, and histopathological presentations. Primary vasculitides most commonly associated with lung parenchymal involvement include small-vessel antineutrophil cytoplasmic autoantibody (ANCA)-associated vasculitides, such as granulomatosis with polyangiitis (GPA), eosinophilic granulomatosis with polyangiitis (EGPA), and microscopic polyangiitis (MPA). Several studies have reported cases of interstitial lung diseases (ILDs) associated with systemic vasculitis, particularly those positive for ANCA associated vasculitis/vasculitidis: AAV. We have selected from our case series different radiological features of pulmonary vasculitis (i.e., solitary or multiple nodules, cavitary lesions, nodules with centrilobular or peribronchial distribution, airspace consolidations, “crazy paving” appearance, interstitial disease), including cases with interstitial lung alterations. Therefore, the aim of this review is to describe the typical clinical manifestations of vasculitides and their main radiologic features (especially AAV).

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