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

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Presentation transcript:

A 34-Year-Old Man Presenting With Gradual Onset of Shortness of Breath and Interstitial Lung Disease Rubinowitz Ami N. , MD, Moon Marianne , MD, Homer Robert , MD, PhD CHEST Volume 133, Issue 4, Pages 1041-1047 (April 2008) DOI: 10.1378/chest.07-2235 Copyright © 2008 The American College of Chest Physicians Terms and Conditions

Figure 1 Posteroanterior chest radiograph demonstrates mild increased interstitial markings in the lower lobes. CHEST 2008 133, 1041-1047DOI: (10.1378/chest.07-2235) Copyright © 2008 The American College of Chest Physicians Terms and Conditions

Figure 2 Transverse high-resolution CT image obtained through the mid-chest at the level of the hila shows bilateral, subpleural areas of ground-glass opacity with minimal fine reticular markings. CHEST 2008 133, 1041-1047DOI: (10.1378/chest.07-2235) Copyright © 2008 The American College of Chest Physicians Terms and Conditions

Figure 3 Transverse high-resolution CT image obtained through the lower one third of the chest at the level of the inferior pulmonary veins shows bilateral patchy areas of ground-glass opacity with subpleural sparing in the lower lobes, and mild traction bronchiectasis (arrows) in the middle lobe. CHEST 2008 133, 1041-1047DOI: (10.1378/chest.07-2235) Copyright © 2008 The American College of Chest Physicians Terms and Conditions

Figure 4 Transverse CT image obtained through the lower one third of the chest (at a comparable level as in Fig 3) following 6 months of treatment with prednisone and cytoxan shows dramatic improvement of ground-glass opacity with minimal residual ground-glass density and mild architectural distortion remaining. CHEST 2008 133, 1041-1047DOI: (10.1378/chest.07-2235) Copyright © 2008 The American College of Chest Physicians Terms and Conditions

Figure 5 Medium power view of lung shows a diffuse expansion of the interstitium with a mixture of loose fibrosis, inflammation, and mild interstitial fibrosis (hematoxylin-eosin, original × 20). CHEST 2008 133, 1041-1047DOI: (10.1378/chest.07-2235) Copyright © 2008 The American College of Chest Physicians Terms and Conditions