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

BMC Pulmonary Medicine

Case Report

Kunio Mizuguchi¹  Masashi Kawamoto¹  Noriko Sudo²  Takana Yamakawa²  Masao Tago²  Atsushi Nambu²  Shozo Fujino³  Masato Watanabe³ 

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

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

DOI  :  10.1186/1471-2466-13-3

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

来源: Springer

【 摘 要 】

BackgroundFocal 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 presentationWe 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.ConclusionWe 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】

CC BY   
© Sudo et al.; licensee BioMed Central Ltd. 2013