Recurrent Fevers, Cough, and Pulmonary Opacities in a Middle-Aged Man

Slides:

Advertisements

Similar presentations

Polymyositis Associated With Severe Interstitial Lung Disease

Advertisements

A 35-Year-Old Man With Fever, Dyspnea, and Diffuse Reticular Opacities

Volume 46, Issue 5, Pages (November 1964)

Rajesh V. Babu, MD, Alicia Romero, MD, Gulshan Sharma, MBBS, MPH, FCCP

Amyloid-associated Cystic Lung Disease

Koichi Nishimura, M.D., Harumi Itoh, M.D. CHEST

Ground-Glass Centrilobular Nodules on Multidetector CT Scan

Volume 102, Issue 4, Pages (October 1992)

Britta K. Sundquist, MD, Paul G. Comber, MD, PhD, Scott H. Beegle, MD

Cavitary Lung Disease with Skin Lesions

Volume 120, Issue 3, Pages (September 2001)

Volume 121, Issue 3, Pages (March 2002)

Volume 140, Issue 6, Pages (December 2011)

Volume 132, Issue 4, Pages (October 2007)

Chest Pain and Progressive Miliary Infiltrates in an Elderly Man

A 48-Year-Old Woman With Headache and Respiratory Failure

Volume 143, Issue 3, Pages (March 2013)

Volume 152, Issue 4, Pages e89-e93 (October 2017)

Volume 143, Issue 4, Pages (April 2013)

A Middle-aged Asthmatic Woman With Unresolving Cough

Volume 133, Issue 6, Pages (June 2008)

Volume 145, Issue 3, Pages (March 2014)

Usual Interstitial Pneumonia Complicating Dyskeratosis Congenita

A 40-Year-Old Man With a Nodular Lung Disease and Skin Rash

Adenopathy and Pulmonary Infiltrates in a Japanese Emigrant in Brazil

A 40-Year-Old Woman With Multiple Lung Nodules

A 67-Year-Old Man With Psoriatic Arthritis and New-Onset Dyspnea

Volume 145, Issue 1, Pages (January 2014)

Volume 140, Issue 1, Pages (July 2011)

Idiopathic Pulmonary Fibrosis: Evolving Concepts

Volume 148, Issue 6, Pages e175-e180 (December 2015)

Dyspnea in a Transplant Recipient With Pulmonary Nodules

Britta K. Sundquist, MD, Paul G. Comber, MD, PhD, Scott H. Beegle, MD

Chok Limsuwat, MD, Philip J. Daroca, MD, Joseph A. Lasky, MD CHEST

Organizing Pneumonia Induced by Nivolumab in a Patient with Metastatic Melanoma Kazuhisa Nakashima, MD, Tateaki Naito, MD, Shota Omori, MD, Shusuke Yoshikawa,

A 20-Year-Old Man With Fever, Chest Pain, and Lung Nodules

Volume 148, Issue 3, Pages e80-e85 (September 2015)

Volume 135, Issue 5, Pages (May 2009)

Fever, Cough, and Weight Loss

Volume 140, Issue 4, Pages (October 2011)

Volume 153, Issue 6, Pages e147-e152 (June 2018)

Otis B. Rickman, DO, Jay H. Ryu, MD, Mary E

A 68-Year-Old Man With Dyspnea on Exertion and Cough

Unusual Diffuse Pulmonary Lymphatic Proliferation in a Young Boy

Volume 142, Issue 3, Pages (September 2012)

Volume 132, Issue 6, Pages (December 2007)

Volume 148, Issue 5, Pages e142-e147 (November 2015)

Anterior Mediastinal Bone-Eroding Mass With Disseminated Lung Lesions

Volume 155, Issue 2, Pages e51-e54 (February 2019)

A 50-Year-Old Man With a Cough and Painful Chest Wall Mass

Diagnosis of Interstitial Lung Diseases

Rubinowitz Ami N. , MD, Moon Marianne , MD, Homer Robert , MD, PhD

A 45-Year-Old Man With Skin Lesions and Pleural Effusion

Fatal Hemoptysis in Ehlers-Danlos Syndrome

Alexander Zider, MD, Nader Kamangar, MD, FCCP CHEST

Volume 137, Issue 5, Pages (May 2010)

Volume 151, Issue 6, Pages e131-e134 (June 2017)

Temozolomide-Associated Organizing Pneumonitis

Volume 155, Issue 3, Pages e69-e74 (March 2019)

A 40-Year-Old Woman With Multiple Pulmonary Nodules

Adult With Recurrent Chest Pain and Vomiting

Volume 134, Issue 1, Pages (July 2008)

Damian R. Compa, MD, Marc A. Judson, MD, FCCP, Scott H. Beegle, MD

Ground-Glass Centrilobular Nodules on Multidetector CT Scan

Luke A. Seaburg, MD, Hiroshi Sekiguchi, MD CHEST

A Rare Cause of Multiple Cavitary Nodules

Volume 155, Issue 4, Pages e91-e96 (April 2019)

A Diagnostic Conundrum

Ann Vu, MD, Robert Vassallo, MD, Jay H. Ryu, MD CHEST

A 40-Year-Old Man With Albinism and Progressive Dyspnea

Presentation transcript:

Recurrent Fevers, Cough, and Pulmonary Opacities in a Middle-Aged Man Philippe R. Bauer, MD, PhD, FCCP, Clive S. Zent, MD, Marie-Christine Aubry, MD, FCCP, Jay H. Ryu, MD, FCCP CHEST Volume 137, Issue 6, Pages 1465-1469 (June 2010) DOI: 10.1378/chest.09-1271 Copyright © 2010 The American College of Chest Physicians Terms and Conditions

Figure 1 Chest CT scan during the first episode showing diffuse centrilobular nodules highly suggestive of subacute hypersensitivity pneumonitis. CHEST 2010 137, 1465-1469DOI: (10.1378/chest.09-1271) Copyright © 2010 The American College of Chest Physicians Terms and Conditions

Figure 2 Transbronchial lung biopsy specimen during the first episode. Photomicrograph shows intraalveolar plugs of proliferating fibroblasts in a myxoid background (hematoxylin and eosin stain; original magnification × 200). CHEST 2010 137, 1465-1469DOI: (10.1378/chest.09-1271) Copyright © 2010 The American College of Chest Physicians Terms and Conditions

Figure 3 Chest radiograph during the second episode. Ill-defined hazy increased density in both bases is more pronounced on the left side, causing partial obscuration of the left hemidiaphragm. CHEST 2010 137, 1465-1469DOI: (10.1378/chest.09-1271) Copyright © 2010 The American College of Chest Physicians Terms and Conditions

Figure 4 Chest CT scan during the second episode. Predominant pattern of randomly distributed (both centrilobular and subpleural) poorly defined nodular opacities (white arrows), more extensive than seen on the initial chest CT scan, with a noticeably different morphology and without evidence of air-space consolidation or ground glass attenuation. CHEST 2010 137, 1465-1469DOI: (10.1378/chest.09-1271) Copyright © 2010 The American College of Chest Physicians Terms and Conditions

Figure 5 Chest radiograph during the second episode with worsening symptoms, showing increase in the diffuse nodular opacities throughout both lungs. CHEST 2010 137, 1465-1469DOI: (10.1378/chest.09-1271) Copyright © 2010 The American College of Chest Physicians Terms and Conditions

Figure 6 Chest CT scan during the second episode with worsening symptoms. Progression of radiologic abnormalities to include diffuse, randomly distributed lung nodules, curvilinear subpleural consolidation and/or atelectasis involving the left base, and evidence of subtle increased peripheral/subpleural reticular densities in the posterior right lung base, suggesting the development of mild fibrosis. CHEST 2010 137, 1465-1469DOI: (10.1378/chest.09-1271) Copyright © 2010 The American College of Chest Physicians Terms and Conditions

Figure 7 Transbronchial lung biopsy specimen during the second episode. Photomicrograph shows intraalveolar plugs of proliferating fibroblasts in a myxoid background, similar to the previous biopsy specimen (hematoxylin and eosin stain; original magnification × 200). CHEST 2010 137, 1465-1469DOI: (10.1378/chest.09-1271) Copyright © 2010 The American College of Chest Physicians Terms and Conditions