Very nice case! But, ha!, I'd bet big bucks that the CT did *not* show ground-glass opacities. In PVOD, the CT typically shows the consequence of venous occlusion: interstitial edema (usually mild in degree) , and often, small pleural effusions. If pulmonary capillary hemangiomatosis is also present, then groundglass-attenuating opacities may be present, usually in the form of groundglass-attenuating, centrilobular nodular opacities, rather than larger, confluent, geographic opacities. Some pathologists say that pulmonary capillary hemangiomatosis is an epiphenomenon when both are present, the PVOD the primary disease.
Nice. Appreciate the additional rads explanation. Many of our cases come from community hospitals with a pulmonologist note of the CT findings. Many opportunities for the true rads to be “lost in translation.”
Thanks for the Info. Clinically I’ve had the experience of patients either declining bx or biopsy being inconclusive. I’ve typically though of PVOD as a diagnosis of exclusion based on RHC demonstrating true PAH hemodynamics with assistance of CTA chest showing b/l mediastinal/hilar adenopathy, GGO, mosaic attenuation +\- effusions. Treatment is always risky having to start vasoldilator therapy at very low doses with extremely close f/u. Nonetheless very nice video. Thanks for your input.
great case! thank you for talking through the ways you differentiate pulmonary disease
Great! Thanks much!
Nice. Thanks for sharing and please keep posting
Can I get a response I have a question about PVOD 🙏🏽 please and thank you in advanced.
Very nice case! But, ha!, I'd bet big bucks that the CT did *not* show ground-glass opacities. In PVOD, the CT typically shows the consequence of venous occlusion: interstitial edema (usually mild in degree) , and often, small pleural effusions. If pulmonary capillary hemangiomatosis is also present, then groundglass-attenuating opacities may be present, usually in the form of groundglass-attenuating, centrilobular nodular opacities, rather than larger, confluent, geographic opacities. Some pathologists say that pulmonary capillary hemangiomatosis is an epiphenomenon when both are present, the PVOD the primary disease.
Nice. Appreciate the additional rads explanation. Many of our cases come from community hospitals with a pulmonologist note of the CT findings. Many opportunities for the true rads to be “lost in translation.”
Thanks for the Info. Clinically I’ve had the experience of patients either declining bx or biopsy being inconclusive. I’ve typically though of PVOD as a diagnosis of exclusion based on RHC demonstrating true PAH hemodynamics with assistance of CTA chest showing b/l mediastinal/hilar adenopathy, GGO, mosaic attenuation +\- effusions. Treatment is always risky having to start vasoldilator therapy at very low doses with extremely close f/u. Nonetheless very nice video. Thanks for your input.