Volume 134, Issue 1, Pages (July 2008)

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Volume 134, Issue 1, Pages 207-212 (July 2008) Diffuse Ground-Glass Opacities in a Patient With Hodgkin Lymphoma and Progressive Respiratory Failure* Myrna C.B. Godoy, MD, Daisuke Nonaka, MD, Bruce G. Raphael, MD, Ioannis Vlahos, MD CHEST Volume 134, Issue 1, Pages 207-212 (July 2008) DOI: 10.1378/chest.07-2491 Copyright © 2008 The American College of Chest Physicians Terms and Conditions

Figure 1 Chest radiograph (anteroposterior view) showing diffuse bilateral airspace opacity, predominantly involving the lower lobes, and a suspected pneumomediastinum (arrow). CHEST 2008 134, 207-212DOI: (10.1378/chest.07-2491) Copyright © 2008 The American College of Chest Physicians Terms and Conditions

Figure 2 HRCT at the level of the tracheal carina (top) and lung bases (bottom) showing diffuse ground-glass opacities and interlobular and intralobular reticulation, predominantly involving the dependent regions of the lungs. There are no pleural effusions. A small pneumomediastinum was confirmed (arrowheads). CHEST 2008 134, 207-212DOI: (10.1378/chest.07-2491) Copyright © 2008 The American College of Chest Physicians Terms and Conditions

Figure 3 Histopathologic features in open lung biopsy specimens of the lingula and left lower lobe. Top: Extensive fibrosis replacing lung parenchyma, resulting in cystic remodeling (arrows) [hematoxylin-eosin, original × 20]. Bottom: Reactive type II pneumocyte proliferation (arrows) [hematoxylin-eosin, original × 400]. CHEST 2008 134, 207-212DOI: (10.1378/chest.07-2491) Copyright © 2008 The American College of Chest Physicians Terms and Conditions

Figure 4 HRCT at the level of the bronchus intermedius (top left) and right lower lobe (bottom left) with respective follow-up HRCT (top right, bottom right) performed 3 months later, after introduction of methylprednisolone, showing marked improvement of the diffuse ground-glass opacities and reticulation, persisting only residual mild peripheral ground-glass opacities (arrows). CHEST 2008 134, 207-212DOI: (10.1378/chest.07-2491) Copyright © 2008 The American College of Chest Physicians Terms and Conditions