Castañer Eva, Alguersuari Anna, Andreu Marta, Gallardo Xavier, Spinu Cristina, Mata Josep M
Department of Radiology, UDIAT-Centre Diagnòstic, Institut Universitari Parc Taulí-UAB, Sabadell, Barcelona, Spain.
Semin Ultrasound CT MR. 2012 Dec;33(6):567-79. doi: 10.1053/j.sult.2012.05.001.
Vasculitis is a destructive inflammatory process affecting blood vessels. Pulmonary vasculitis may develop secondary to other conditions or constitute a primary idiopathic disorder. Thoracic involvement is most common in primary idiopathic large-vessel vasculitides (Takayasu arteritis, giant cell arteritis, Behçet disease) and primary antineutrophil cytoplasmic autoantibody-associated small-vessel vasculitides (Wegener granulomatosis, microscopic polyangiitis, Churg-Strauss syndrome). Primary pulmonary vasculitides are rare, and their signs and symptoms are nonspecific, overlapping with those of infections, connective tissue diseases, and malignancies. The radiologic findings in primary pulmonary vasculitis vary widely and can include vessel wall thickening, nodular or cavitary lesions, ground-glass opacities, and consolidations, among others. Diffuse alveolar hemorrhage usually results from primary small-vessel vasculitis in the lungs. To diagnose vasculitis, medical teams must recognize characteristic combinations of clinical, radiologic, laboratory, and histopathologic features.
血管炎是一种影响血管的破坏性炎症过程。肺血管炎可能继发于其他疾病，也可能是一种原发性特发性疾病。胸部受累在原发性特发性大血管血管炎（大动脉炎、巨细胞动脉炎、白塞病）和原发性抗中性粒细胞胞浆抗体相关小血管血管炎（韦格纳肉芽肿、显微镜下多血管炎、变应性肉芽肿性血管炎）中最为常见。原发性肺血管炎较为罕见，其体征和症状不具有特异性，与感染、结缔组织病和恶性肿瘤的体征和症状重叠。原发性肺血管炎的影像学表现差异很大，可包括血管壁增厚、结节状或空洞性病变、磨玻璃影和实变等。弥漫性肺泡出血通常由肺部原发性小血管炎引起。为了诊断血管炎，医疗团队必须识别临床、影像学、实验室和组织病理学特征的典型组合。
