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This case series reports three UPF patients on HRCT, each linked to a distinct vascular abnormality, including both congenital and acquired 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are cardiovascular causes of unilateral pulmonary fibrosis often missed?","Question",{"text":63,"@type":64},"They are frequently underrecognized because affected patients may lack a suggestive clinical history, and symptoms can be absent or mild and nonspecific, leading to incidental detection on imaging.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"What vascular abnormalities were associated with the three reported UPF cases?",{"text":68,"@type":64},"The cases were linked to unilateral absence of the pulmonary artery, chronic pulmonary thromboembolism, and pulmonary artery branch hypoplasia.",{"name":70,"@type":61,"acceptedAnswer":71},"How does the article aim to improve diagnosis of unilateral fibrotic lung disease?",{"text":72,"@type":64},"By highlighting diverse radiologic patterns of vascular UPF on HRCT and underscoring the need to consider vascular causes in the differential diagnosis, enabling a more appropriate etiologic 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1072  \nAvailable online [at](at www.sciencedirect.com)[ www.sciencedirect.com](at www.sciencedirect.com)  \njournal [homepage:](homepage: www.elsevier.com/locate/radcr)[ www.elsevier.com/locate/radcr](homepage: www.elsevier.com/locate/radcr)  \n| Case Report\u003Cbr>Vascular etiologies of unilateral pulmonary fibrosis: Case series and literature overview ✩,✩✩\u003Cbr>Diletta Cozzi, MDa,∗, Luca Gozzi, MDb, Edoardo Cavigli, MDa, Chiara Moroni, MDa, Alessandra Bindi, MDa, Elisabetta Rosi, MDc, Sara Tomassetti, MDd, Vittorio Miele, MDa,b\u003Cbr>a Department of Emergency Radiology, Careggi University Hospital, Florence, Italy\u003Cbr>b Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Florence, Florence, Italy c Department of Pulmonology, Careggi University Hospital, Florence, Italy\u003Cbr>dUnit of Interventional Pulmonology, Department of Experimental and Clinical Medicine, Careggi University Hospital, Florence, Italy |  |  |\n| --- | --- | --- |\n| a r t i c l e i n f o |  | a b s t r a c t |\n| Article history:\u003Cbr>Received 25 July 2025 Revised 6 November 2025 Accepted 7 November 2025 |  | Unilateral pulmonary fibrosis (UPF) is an uncommon manifestation of interstitial lung disease that may arise from various causes. Among those, cardiovascular etiology is often overlooked because affected patients do not present history of exposure of any kind, are frequently asymptomatic or present only mild, subtle and nonspecific symptoms. As a result, these cases are usually identified incidentally on imaging performed for unrelated reasons, contributing to under recognition of their true prevalence. We report 3 patients with incidentally detected UPF on high-resolution computed tomography (HRCT), each associated with a distinct vascular abnormality, both congenital and acquired conditions: unilateral absence of the pulmonary artery, chronic pulmonary thromboembolism, and pulmonary artery branch hypoplasia. Our aim with this case series is to highlights the diverse radiologic patterns of vascular UPF, underscoring the importance of considering vascular causes in the differential diagnosis of unilateral fibrotic lung disease.\u003Cbr>© 2025 The Authors. Published by Elsevier Inc. on behalf of University of Washington.\u003Cbr>This is an open access article under the CC BY license\u003Cbr>([http://creativecommons.org/licenses/by/4.0/](http://creativecommons.org/licenses/by/4.0/)) |\n| Keywords:\u003Cbr>Lung fibrosis Unilateral lung fibrosis HRCT\u003Cbr>Pulmonary embolism CTEPH |  |  |\n\nIntroduction  \nPulmonary fibrosis (PF) is typically a bilateral and progressive interstitial lung disease (ILD), often idiopathic, although  \nit can also be secondary to environmental exposure, connective tissue disease or drug toxicity [1–3] . Despite both lungs being exposed to the same toxics or triggers, some degree of asymmetric lung involvement may occur. However, purely or predominantly unilateral pulmonary fibrosis (UPF) is a very  \n✩ Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.  \n✩✩ Acknowledgment: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.  \n∗ Corresponding author.  \nE-mail address: [dilettacozzi@gmail.com](dilettacozzi@gmail.com) (D. Cozzi).  \n[https://doi.org/10.1016/j.radcr.2025.11.010](https://doi.org/10.1016/j.radcr.2025.11.010)  \n1930-0433/© 2025 The Authors. Published by Elsevier Inc. on behalf of University of Washington. This is an open access article under the CC BY license ([http://creativecommons.org/licenses/by/4.0/](http://creativecommons.org/licenses/by/4.0/))  \nFig. 1 – Case 1 – Unilateral absence of the right pulmonary artery (UAPA) causing unilateral pulmonary fibrosis. HRCT images show irregular subpleural interstitial thickening and honeycombing-like foci confined to the right lun","cbCaio7Sb1VjV2OZ","https://ap.wps.com/l/cbCaio7Sb1VjV2OZ","pdf",2082370,"English","# Introduction\n## Vascular mechanisms in unilateral pulmonary fibrosis\n# Case series overview\n## Case 1\n## Case 2\n## Case 3","[{\"question\":\"Why are cardiovascular causes of unilateral pulmonary fibrosis often missed?\",\"answer\":\"They are frequently underrecognized because affected patients may lack a suggestive clinical history, and symptoms can be absent or mild and nonspecific, leading to incidental detection on imaging.\"},{\"question\":\"What vascular abnormalities were associated with the three reported UPF cases?\",\"answer\":\"The cases were linked to unilateral absence of the pulmonary artery, chronic pulmonary thromboembolism, and pulmonary artery branch hypoplasia.\"},{\"question\":\"How does the article aim to improve diagnosis of unilateral fibrotic lung disease?\",\"answer\":\"By highlighting diverse radiologic patterns of vascular UPF on HRCT and underscoring the need to consider vascular causes in the differential diagnosis, enabling a more appropriate etiologic work-up.\"}]","Vascular etiologies of unilateral pulmonary fibrosis - Case series and literature overview | PDF",1790602372,15]