Volume 140, Issue 4, Pages 1086-1089 (October 2011) Pulmonary Hypertension Presenting With Apnea, Cyanosis, and Failure to Thrive in a Young Child  Susanne Navarini, MD, Barbara Bucher, Mladen Pavlovic, Jean-Pierre Pfammatter, Carmen Casaulta, Frank Brasch, Matthias Griese, Nicolas Regamey  CHEST  Volume 140, Issue 4, Pages 1086-1089 (October 2011) DOI: 10.1378/chest.10-2607 Copyright © 2011 The American College of Chest Physicians Terms and Conditions

Figure 1 Chest radiograph reveals a normal-sized heart with ill-defined diffuse increased lung density with resultant poorly defined pulmonary vasculature. Neither pleural effusion nor dilatation of the pulmonary arteries is present. CHEST 2011 140, 1086-1089DOI: (10.1378/chest.10-2607) Copyright © 2011 The American College of Chest Physicians Terms and Conditions

Figure 2 High-resolution CT scan of the chest shows bilateral diffuse ground-glass opacities sparing the right mediobasal lower segment. There is considerable noise throughout the image, creating an impression of nodularity. The interlobular septae are conspicuous by their absence. There is no pleural effusion. The heart size and the diameter of the central pulmonary artery are normal. CHEST 2011 140, 1086-1089DOI: (10.1378/chest.10-2607) Copyright © 2011 The American College of Chest Physicians Terms and Conditions

Figure 3 A, Lung histology shows multiple areas with thickening of the alveolar septae due to abnormal proliferating capillaries, hematoxylin-eosin stained. The architecture of the small pulmonary arteries, veins, and bronchioles is normal; there are no signs of interstitial fibrosis (original magnification ×65). B, Capillary proliferation was confirmed by immunohistological staining with anti-CD31 antibodies (original magnification ×65). CHEST 2011 140, 1086-1089DOI: (10.1378/chest.10-2607) Copyright © 2011 The American College of Chest Physicians Terms and Conditions