Clinical and imaging features of pulmonary vasculitis

Abstract

Pulmonary vasculitis includes two types: primary vasculitis and secondary vasculitis.Secondary pulmonary vasculitis consists of infectious diseases, connective tissue diseases, malignant tumor and allergic diseases.Primary pulmonary vasculitis is usually classified into large, middle and small vessel vasculitis according to the size of the involved vessels.Pulmonary vascular involvement is common in primary large vessel vasculitis, including Takayasu arteritis, giant cell arteritis (GCA) and Behcet′s disease, and primary anti-neutrophil cytoplasmic antibody (ANCA) associated vasculitis, including granulomatosis with polyangiitis (GPA), microscopic polyangiitis (MPA) and eosinophilic granulomatosis with polyangiitis (EGPA). The image findings of primary pulmonary vasculitis are very diverse, including thickening of the vascular wall, nodular shadows, cavity, ground glass opacity and consolidation.Primary pulmonary vasculitis often leads to diffuse alveolar hemorrhage (DAH). Compared with the chest radiograph, chest computer tomography (CT) is more capable of showing the characteristics and extent of pulmonary vasculitis.The diagnosis of pulmonary vasculitis is very challenging.It is necessary to make a comprehensive judgment by the clinical features, imaging characteristics, laboratory findings and histopathological features. Key words: Takayasu arteritis; Giant cell arteritis; Behcet′s disease; Primary anti-neutrophil cytoplasmic antibody associated vasculitis; Diffuse alveolar hemorrhage; Chest computer tomography