RT Journal Article
SR Electronic
T1 Pulmonary vasculitis mimicking chronic thromboembolic disease
JF BMJ Case Reports
JO BMJ Case Reports
FD BMJ Publishing Group Ltd
SP e228409
DO 10.1136/bcr-2018-228409
VO 12
IS 4
A1 Noor Ali
A1 Lynsey Clarke
A1 Robert Valentine MacKenzie Ross
A1 Graham Robinson
YR 2019
UL http://casereports.bmj.com/content/12/4/e228409.abstract
AB A 29-year-old female patient presented with chest pain, breathlessness and syncope on the background of constitutional symptoms, oral ulceration and a rash. Multiple investigations were performed, including a CT pulmonary angiogram (CTPA) that was initially felt to show imaging features consistent with a diagnosis of chronic thromboembolic disease (CTED). The patient was referred to a tertiary pulmonary hypertension centre and the possibility of pulmonary vasculitis was raised. Subsequent positron emission tomography (PET)-CT revealed imaging features supporting this diagnosis. The patient was treated with intravenous cyclophosphamide infusions, following which her symptoms improved. A repeat PET-CT 6 months after treatment showed resolution in pulmonary artery and mediastinal uptake, but persistence of pulmonary artery occlusions on a repeat CTPA. A final diagnosis of pulmonary vasculitis secondary to Behçet’s disease was made. This case report aims to raise awareness of the imaging features of CTED and its mimics.