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EXAMINATION: CT chest without contrast. CLINICAL INDICATION: Primary pulmonary hypertension. Previous CT had bilateral lung infiltrates. COMPARISON: 07/09/2013. TECHNIQUE: Helical CT through the chest without contrast. Axial 2.5 mm (standard algorithm) and 1.25 mm (high-resolution lung algorithm), as well as sagittal and coronal reformatted images (to include MIP and minIP) were reviewed.  FINDINGS:  MEDIASTINUM: Support tubes and lines: There is a right jugular line in place. Base of neck/thyroid: Thyroid gland is not visualized, postoperative status. Lymph Nodes: There are no enlarged lymph nodes in the supraclavicular region. There are stable small lymph nodes in both axilla showing fatty hila. Within the limits of a noncontrast evaluation, there is no obvious change in the mediastinal or hilar contours to suggest increased adenopathy. Borderline prominent lymph nodes are again seen in the aortopulmonary window, paratracheal region as before. Trachea: Normal. Esophagus: Normal. Aorta: Normal caliber. Heart: Within the limits of a noncontrast exam, there is unchanged appearance of moderate to severe enlargement of the right heart chambers. Coronary arteries: No calcifications. Pericardium: No change in small pericardial effusion.  Pulmonary arteries: Severe enlargement of main pulmonary artery is again noted measuring up to 4.1 cm, without significant change since the previous exam. LUNGS AND PLEURA: Lungs: Diffuse mosaic attenuation associated with groundglass opacities is again noted in both lungs with no zonal predominance. This is associated with septal thickening. This is mainly secondary to differential perfusion. Within the relatively higher attenuation zones, there are multiple small vascular ectasias identified as seen on series 4, image #102. Compared to previous exam, overall, the distribution is fairly stable. Changes of vascular ectasias are better appreciated on coronal MIP series 603. Some of the vessels show nodular configuration, for example image #14 on series 603. Pleura: No effusion, thickening or calcification. OTHER FINDINGS: None. UPPER ABDOMEN: Hepatosplenomegaly appears unchanged. BONES/SOFT TISSUES: No focal lesion.