Diseases Involving the Lung Peribronchovascular Region: a CT-Pathologic Classification.

Overview

TOPIC IMPORTANCE: Chest computed tomography (CT) holds a major role in the diagnosis of lung disease, many of which affect the peri-bronchovascular (PBV) region. Identification and categorization of PBV abnormalities on CT can assist in formulating a differential diagnosis and directing further diagnostic evaluation. REVIEW FINDINGS: The PBV region of the lung encompasses the pulmonary arteries, airways, and lung interstitium. Understanding disease processes associated with structures of the PBV region and their appearances on CT aids in prompt diagnosis. This manuscript reviews current knowledge in anatomy and pathology of the lung interstitium composed of intercommunicating pre-lymphatic spaces, lymphatics, collagen bundles, lymph nodes, bronchial arteries; diffuse lung diseases that present in a PBV distribution; and an approach to classifying diseases according to patterns of imaging presentations. Lung PBV diseases can appear on CT as diffuse thickening, fibrosis, masses/mass-like consolidation, ground glass or air-space consolidation, and cysts, acknowledging some disease may have multiple presentations.