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Erschienen in: Pediatric Radiology 13/2022

11.06.2022 | Original Article

Chest computed tomography findings of ground-glass nodules with enhancing central vessel/nodule in pediatric patients with BMPR2 mutations and plexogenic arteriopathy

verfasst von: Jason P. Weinman, David A. Mong, LaDonna J. Malone, Dunbar D. Ivy, Robin R. Deterding, Csaba Galambos

Erschienen in: Pediatric Radiology | Ausgabe 13/2022

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Abstract

Background

Germline mutation in bone morphogenetic protein type II (BMPR2) is the most common cause of idiopathic/heritable pulmonary hypertension in pediatric patients. Despite the discovery of this gene there are no known descriptions of the CT or CT angiography findings in these children.

Objective

To correlate the clinical presentation, pathology and chest CT findings in pediatric patients with pulmonary hypertension caused by mutations in the BMPR2 gene.

Materials and methods

We performed a search to identify pediatric patients with a BMPR2 mutation and CT or CT angiography with the clinical history of pulmonary hypertension. Three pediatric radiologists reviewed the children’s CT imaging findings and ranked the dominant findings in order of prevalence via consensus.

Results

We identified three children with pulmonary hypertension and confirmed germline BMPR2 mutations, two of whom had undergone lung biopsy. We then correlated the imaging findings with histopathology and clinical course.

Conclusion

All of our patients with BMPR2 mutations demonstrated a distinct CT pattern of ground-glass nodules with a prominent central enhancing vessel/nodule. These findings correlated well with the pathological findings of plexogenic arteriopathy.
Literatur
1.
3.
Zurück zum Zitat Lane KB, Machado RD, Pauciulo MW et al (2000) Heterozygous germline mutations in BMPR2, encoding a TGF-beta receptor, cause familial primary pulmonary hypertension. Nat Genet 26:81–84CrossRefPubMed Lane KB, Machado RD, Pauciulo MW et al (2000) Heterozygous germline mutations in BMPR2, encoding a TGF-beta receptor, cause familial primary pulmonary hypertension. Nat Genet 26:81–84CrossRefPubMed
4.
Zurück zum Zitat Evans JDW, Girerd B, Montani D et al (2016) BMPR2 mutations and survival in pulmonary arterial hypertension: an individual participant data meta-analysis. Lancet Respir Med 4:129–137CrossRefPubMedPubMedCentral Evans JDW, Girerd B, Montani D et al (2016) BMPR2 mutations and survival in pulmonary arterial hypertension: an individual participant data meta-analysis. Lancet Respir Med 4:129–137CrossRefPubMedPubMedCentral
5.
Zurück zum Zitat Heldin CH, Miyazono K, Ten Dijke P (1997) TGF-β signalling from cell membrane to nucleus through SMAD proteins. Nature 390:465–471CrossRefPubMed Heldin CH, Miyazono K, Ten Dijke P (1997) TGF-β signalling from cell membrane to nucleus through SMAD proteins. Nature 390:465–471CrossRefPubMed
6.
Zurück zum Zitat Morrell NW (2006) Pulmonary hypertension due to BMPR2 mutation: a new paradigm for tissue remodeling? Proc Am Thorac Soc 3:680–686CrossRefPubMed Morrell NW (2006) Pulmonary hypertension due to BMPR2 mutation: a new paradigm for tissue remodeling? Proc Am Thorac Soc 3:680–686CrossRefPubMed
7.
Zurück zum Zitat Croix CMS, Steinhorn RH (2016) New thoughts about the origin of plexiform lesions. Am J Respir Crit Care Med 193:484–485CrossRef Croix CMS, Steinhorn RH (2016) New thoughts about the origin of plexiform lesions. Am J Respir Crit Care Med 193:484–485CrossRef
8.
Zurück zum Zitat Grosse C, Grosse A (2010) CT findings in diseases associated with pulmonary hypertension: a current review. Radiographics 30:1753–1777CrossRefPubMed Grosse C, Grosse A (2010) CT findings in diseases associated with pulmonary hypertension: a current review. Radiographics 30:1753–1777CrossRefPubMed
9.
Zurück zum Zitat Compton GL, Florence J, MacDonald C et al (2015) Main pulmonary artery–to–ascending aorta diameter ratio in healthy children on MDCT. AJR Am J Roentgenol 205:1322–1325CrossRefPubMed Compton GL, Florence J, MacDonald C et al (2015) Main pulmonary artery–to–ascending aorta diameter ratio in healthy children on MDCT. AJR Am J Roentgenol 205:1322–1325CrossRefPubMed
10.
Zurück zum Zitat Brody AS, Guillerman RP, Hay TC et al (2010) Neuroendocrine cell hyperplasia of infancy: diagnosis with high-resolution CT. AJR Am J Roentgenol 194:238–244CrossRefPubMedPubMedCentral Brody AS, Guillerman RP, Hay TC et al (2010) Neuroendocrine cell hyperplasia of infancy: diagnosis with high-resolution CT. AJR Am J Roentgenol 194:238–244CrossRefPubMedPubMedCentral
11.
Zurück zum Zitat Weinman JP, Manning DA, Liptzin DR et al (2017) HRCT findings of childhood follicular bronchiolitis. Pediatr Radiol 47:1759–1765CrossRefPubMed Weinman JP, Manning DA, Liptzin DR et al (2017) HRCT findings of childhood follicular bronchiolitis. Pediatr Radiol 47:1759–1765CrossRefPubMed
12.
Zurück zum Zitat Weinman JP, White CJ, Liptzin DR et al (2018) High-resolution CT findings of pulmonary interstitial glycogenosis. Pediatr Radiol 48:1066–1072CrossRefPubMed Weinman JP, White CJ, Liptzin DR et al (2018) High-resolution CT findings of pulmonary interstitial glycogenosis. Pediatr Radiol 48:1066–1072CrossRefPubMed
13.
Zurück zum Zitat LeMoine BD, Browne LP, Liptzin DR et al (2019) High-resolution computed tomography findings of thyroid transcription factor 1 deficiency (NKX2–1 mutations). Pediatr Radiol 49:869–875CrossRefPubMed LeMoine BD, Browne LP, Liptzin DR et al (2019) High-resolution computed tomography findings of thyroid transcription factor 1 deficiency (NKX2–1 mutations). Pediatr Radiol 49:869–875CrossRefPubMed
14.
Zurück zum Zitat Galambos C, Sims-Lucas S, Abman SH, Cool CD (2016) Intrapulmonary bronchopulmonary anastomoses and plexiform lesions in idiopathic pulmonary arterial hypertension. Am J Respir Crit Care Med 193:574–576CrossRefPubMedPubMedCentral Galambos C, Sims-Lucas S, Abman SH, Cool CD (2016) Intrapulmonary bronchopulmonary anastomoses and plexiform lesions in idiopathic pulmonary arterial hypertension. Am J Respir Crit Care Med 193:574–576CrossRefPubMedPubMedCentral
15.
Zurück zum Zitat Townsley MI (2013) Structure and composition of pulmonary arteries, capillaries and veins. Compr Physiol 2:675–709 Townsley MI (2013) Structure and composition of pulmonary arteries, capillaries and veins. Compr Physiol 2:675–709
16.
Zurück zum Zitat Oshima K, Crockett ES, Joshi SR et al (2019) Aneurysm-type plexiform lesions form in supernumerary arteries in pulmonary arterial hypertension: potential therapeutic implications. Am J Physiol Lung Cell Mol Physiol 317:L805–L815CrossRefPubMedPubMedCentral Oshima K, Crockett ES, Joshi SR et al (2019) Aneurysm-type plexiform lesions form in supernumerary arteries in pulmonary arterial hypertension: potential therapeutic implications. Am J Physiol Lung Cell Mol Physiol 317:L805–L815CrossRefPubMedPubMedCentral
17.
Zurück zum Zitat Westöö C, Norvik C, Peruzzi N et al (2021) Distinct types of plexiform lesions identified by synchrotron-based phase contrast micro-CT. Am J Physiol Cell Mol Physiol 321:L17–L28CrossRef Westöö C, Norvik C, Peruzzi N et al (2021) Distinct types of plexiform lesions identified by synchrotron-based phase contrast micro-CT. Am J Physiol Cell Mol Physiol 321:L17–L28CrossRef
18.
Zurück zum Zitat Rodríguez-Roisin R, Krowka MJ, Hervé P, Fallon MB (2004) Pulmonary-hepatic vascular disorders (PHD). Eur Respir J 24:861–880CrossRefPubMed Rodríguez-Roisin R, Krowka MJ, Hervé P, Fallon MB (2004) Pulmonary-hepatic vascular disorders (PHD). Eur Respir J 24:861–880CrossRefPubMed
19.
Zurück zum Zitat Aldenkortt F, Aldenkortt M, Caviezel L et al (2014) Portopulmonary hypertension and hepatopulmonary syndrome. World J Gastroenterol 20:8072–8081CrossRefPubMedPubMedCentral Aldenkortt F, Aldenkortt M, Caviezel L et al (2014) Portopulmonary hypertension and hepatopulmonary syndrome. World J Gastroenterol 20:8072–8081CrossRefPubMedPubMedCentral
20.
Zurück zum Zitat Ghigna MR, Guignabert C, Montani D et al (2016) BMPR2 mutation status influences bronchial vascular changes in pulmonary arterial hypertension. Eur Respir J 48:1668–1681CrossRefPubMed Ghigna MR, Guignabert C, Montani D et al (2016) BMPR2 mutation status influences bronchial vascular changes in pulmonary arterial hypertension. Eur Respir J 48:1668–1681CrossRefPubMed
Metadaten
Titel
Chest computed tomography findings of ground-glass nodules with enhancing central vessel/nodule in pediatric patients with BMPR2 mutations and plexogenic arteriopathy
verfasst von
Jason P. Weinman
David A. Mong
LaDonna J. Malone
Dunbar D. Ivy
Robin R. Deterding
Csaba Galambos
Publikationsdatum
11.06.2022
Verlag
Springer Berlin Heidelberg
Erschienen in
Pediatric Radiology / Ausgabe 13/2022
Print ISSN: 0301-0449
Elektronische ISSN: 1432-1998
DOI
https://doi.org/10.1007/s00247-022-05413-8

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