CTICasesHemosiderosis in Pulmonary Arterial Hypertension
Imaging findings
CT chest shows severe main pulmonary artery dilation and bilateral centrilobular ground-glass nodules. Explant pathology shows marked pulmonary arteriolar thickening with extensive peri-arteriolar hemorrhage and hemosiderin-laden macrophages.
Key takeaways
In patients with severe pulmonary arterial hypertension (PAH), chronic high intravascular pressures can cause micro-hemorrhage from the small arterioles into the adjacent alveoli. This leads to peri-arteriolar hemosiderin deposition, presenting on CT as centrilobular ground-glass nodules, mimicking PVOD or PCH.
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