Pulmonary focal fibrosis associated with microscopic arterio-venous fistula manifesting as focal ground-glass opacity on thin-section CT

BMC Pulmonary Medicine

Masao Tago²  Kunio Mizuguchi³  Masato Watanabe¹  Shozo Fujino¹  Masashi Kawamoto³  Takana Yamakawa²  Atsushi Nambu²  Noriko Sudo² 

[1] Department of Surgery, Teikyo University Mizonokuchi Hospital, 3-8-3 Mizonokuchi Takatsu-ku, Kawasaki City, Kanagawa, 213-8507, Japan;Department of Radiology, Teikyo University Mizonokuchi Hospital, 3-8-3 Mizonokuchi Takatsu-ku, Kawasaki City, Kanagawa, 213-8507, Japan;Department of Clinical Pathology, Teikyo University Mizonokuchi Hospital, 3-8-3 Mizonokuchi Takatsu-ku, Kawasaki City, Kanagawa, 213-8507, Japan

关键词: Arterio-venous fistula;    CT;    Lung;    Focal fibrosis;    Ground-glass opacity;   

Others  :  1131303
DOI  :  10.1186/1471-2466-13-3

 received in 2012-11-02, accepted in 2013-01-10,  发布年份 2013

【 摘 要 】

Background

Focal ground-glass opacity (GGO) on thin-section computed tomography (CT) may be seen in atypical adenomatous hyperplasia (AAH), adenocarcinoma in situ that has recently been renamed from bronchioloalveolar carcinoma (BAC) and various benign conditions.

Case presentation

We report a case of pulmonary focal fibrosis associated with microscopic arterio-venous fistula (AVF), which showed a focal area of GGO on thin-section CT. The patient was a 58-year-old woman with a GGO on thin-section CT which had increased in size over the period of 2 years. Slightly dilated vessels and thickened interlobular septa were also noted around the GGO. It was diagnosed preoperatively as adenocarcinoma in situ and a partial lung resection by video-assisted thoracic surgery (VATS) was performed. Pathological examination yielded a diagnosis of focal fibrosis associated with microscopic AVF.

Conclusion

We speculate that the focal fibrosis was produced by a prolonged congestion due to the AVF and that the dilated vessels and thickening of interlobular septa on thin-section CT related to the AVF. Microscopic AVF may be one of the etiologies of focal fibrosis showing focal GGO on thins-section CT. Dilated vessels and thickened interlobular septa around the GGO might offer a clue to the diagnosis of this disease entity. In addition, it should be noted that focal fibrosis may increase in size.

【 授权许可】

   
2013 Sudo et al.; licensee BioMed Central Ltd.

【 图 表 】

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Figure 2.

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