CTICasesStage-Stage NSIP with Transient PA filling defects
Imaging findings
CT angiography shows smoke-like filling defects in the lobar pulmonary arteries with slow blood flow, associated with severe lower-lobe-predominant NSIP-like fibrosis and pulmonary hypertension, which was twice misdiagnosed as acute PE.
Key takeaways
In patients with severe end-stage interstitial lung disease, increased pulmonary vascular resistance leads to sluggish flow in the lower lobe pulmonary arteries. On CT angiography, this slow flow can manifest as transient, poorly-defined filling defects (smoke/mixing artifact) that mimic pulmonary embolism.
AI-assisted summary — may contain errors. Verify against the source video. Learn more
More from this webinar
- Septic Lakes in Interstitial Pulmonary EdemaVascular
- Scleroderma-Rheumatoid Arthritis Overlap with UIPAutoimmune
- Anti-Jo-1 Anti-Synthetase Syndrome Interstitial Lung DiseaseAutoimmune
- Benign Metastasizing LeiomyomaNeoplastic
- DIPNECH with Carcinoid TumorletsNeoplastic
- Metastatic Paraganglioma Mimicking DIPNECHNeoplastic
- Syphilitic Aortitis (Historical Cases)Infection
- Misplaced Swan-Ganz Catheter via Left Superior Intercostal VeinIatrogenic
See all cases from April 30, 2020 →
Related ILD cases
- Dendriform Pulmonary Ossification in UIP
- Chronic Hypersensitivity Pneumonitis
- IPF progressing from recurrent organizing pneumonia to UIP
- Desquamative interstitial pneumonia (DIP) or amyloidosis
- Rapidly progressive pulmonary fibrosis from acute DAD
- Granulomatous-lymphocytic interstitial lung disease (GLILD) in CVID