Takeshi Johkoh MD, PhD, Presenter: Research Consultant, Bayer AG Research Consultant, F. Hoffman-La Roche Ltd

Kiminori Fujimoto MD, PhD, Abstract Co-Author: Nothing to Disclose

Hiroaki Arakawa MD, Abstract Co-Author: Nothing to Disclose

Tomonori Tanaka MD, Abstract Co-Author: Nothing to Disclose

Junya Fukuoka, Abstract Co-Author: Nothing to Disclose

Noriyuki Tomiyama MD, PhD, Abstract Co-Author: Nothing to Disclose

Diffuse peribronchovascular opacities on CT, also called “twitter sign” were defined as areas with ground-glass attenuation or airspace consolidation which diffusely distribute along relatively central bronchus and pulmonary arteries on CT　(Fig). Although various diseases share this abnormality, disease spectrum, frequency, and pathological backgrounds have been still unclear. The purpose of the study was to profile the diseases whish show this unique finding and to demonstrate its pathological backgrounds

From 2008 to 2012, at four institutes, 42 patients showed diffuse peribronchovascular opacities on CT. Clinical diagnosis, clinical course and prognosis were abstracted from each hospital record. The patients ranged from 28 to 70 years of age (mean42), and included 22 males and 20 females. Two observers independently evaluated CT findings .Three cases were done surgical lung biopsy and two cases were done autopsy. In these five cases, precise radiologic pathologic correlation was done.

Clinical diagnosis include 17 drug induced penumonitis (40%), 10 collagen vascular disease (24%), seven cryptogenic organizing pneumonia (17%), three non-specific interstitial pneumonia (7%), two acute respiratory distress syndrome (ARDS) (5%), two acute interstitial pneumonia (5%), and one pneumocystis pneumonia(2%). Ten cases (24%) showed acute process, 27 (48%) showed subacute one, and remaining five (12%) showed chronic one. Forty cases (95%) showed good response to treatment and recovered. In two autopsy cases, peribronchovascular opacities corresponded to organization, fibrosis, and cellular infiltration along central bronchus and pulmonary arteries. In all cases with autopsy and surgical biopsy, pathological diagnosis was organizing pneumonia supervening with fibrosis.

Although the diseases with diffuse peribronchovascular opacities are rare, they seem to share common clinical and pathological findings such as subacute or acute onset, good prognosis, and organizing pneumonia with fibrosis. A new disease entity may be defined by using imaging method.

Diseases with diffuse peribronchovascular opacities on CT share common clinical and pathological findings such as such as subacute or acute onset, good prognosis, and organizing pneumonia with fibrosis

Johkoh, T, Fujimoto, K, Arakawa, H, Tanaka, T, Fukuoka, J, Tomiyama, N, Diffuse Peribronchovascular Opacities on CT: Profiling and Pathological Backgrounds of this Unique Finding.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14015431.html