Pulmonary Vein Stenosis Mimicking Nonspecific Interstitial Pneumonia

Figure 1

(a) and (b) Axial computed tomography (CT) images of prepulmonary vein stenting demonstrate patchy opacities and ground-glass and septal thickening reflecting manifestations of pulmonary vein stenosis with congestion and edema. Opacities are most pronounced in the left upper lobe secondary to complete occlusion of the superior left pulmonary vein ostium. (c) and (d) Follow-up axial CT images of prepulmonary vein stenting demonstrate progression of patchy opacities and ground-glass compatible with increased pulmonary venous congestion and edema. Additionally, small pleural effusions are now visible. (e) and (f) Cardiac CT shows narrowing of the right superior and inferior pulmonary vein ostia (arrows). Although not shown, narrowing of the left inferior ostium and complete occlusion of the left superior pulmonary vein ostium was noted. (g) Contrast-enhanced CT of postpulmonary vein stenting demonstrates marked improvement of pulmonary vein narrowing. The superior left pulmonary vein ostium was not stented and remained occluded. (h) Axial chest CT in lung windows shows substantial improvement of ground-glass and septal thickening. Findings remain the most pronounced in the left upper lobe, as the superior left pulmonary vein ostium was not stented.

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