In our experience in Toronto, the lungs and pleura of children who have had no previous thoractomy, chemotherapy, or thoracic radiation appear clear on CT. In the hilar regions the large arteries and veins are seen branching together with major bronchi as they enter the lung. The vessels normally appear unexpectedly prominent on transverse scans, and it may be extremely difficult, particularly in younger children, to differentiate these structures from enlarged hilar lymph nodes, even with intravenous contrast enhancement. The pulmonary vessels are usually the only normal structures that can be seen silhouetted against the low attenuation of the lung parenchyma. They branch several times and become progressively smaller as they course toward the periphery of the lung. It is impossible to differentiate veins and arteries in the peripheral lung fields. The vessels terminate before reaching the pleura. Occasionally, small normal subpleural lymph nodes may be seen and may mimic metastases (see Fig. 5.7).
KeywordsOsteogenic Sarcoma Lung Parenchyma Pulmonary Nodule Lung Nodule Lung Field
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