Centrilobular nodules are combined with lack of PFO and worse haemodynamic profile in IPAH patients

Abstract

Inhomogeneity of lung parenchyma is described occasionally on high resolution computed tomography of the lung (HRCT) in IPAH. The prevalence and clinical significance of such pathology is uncertain. The aim of the present study was to assess whether the presence of lung inhomogeneity in IPAH was combined with more severe pulmonary hypertension and/or worse survival. Material: 56 IPAH patients (43 females, 13 males, median age 44 years) entered the study. HRCT scans were reviewed retrospectively by the experienced radiologist, not aware about the clinical data of the patients. Results: Centrilobular nodules (CN) were found in 10 patients (18%) ( in 7 of them – at diagnosis, in 3- in the course of IPAH). Focal ground glass opacities (FGGO) were described in 12 patients (21%). No lymphadenopathy or septal lines suggestive of PVOD were found. No evidence of persistent foramen ovale (PFO), significantly more frequent haemoptysis, and higher mean right atrial pressure (mRAP) were observed in CN patients compared to those with no parenchymal abnormalities (NPA) on HRCT. Conclusion: CN presence in IPAH patients was combined with haemoptysis, lack of PFO and higher mRAP, but had no significant influence on survival.