A 53-yr-old man with dyspnea (ATS Gr.IV) onset 2 개월 전, recent agg. 10 일 전  Ex-smoker (1.5pack x 20yr, 13 년 전 부터 금연 )  사무직  2 개월 전 dry cough develop.

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Presentation transcript:

A 53-yr-old man with dyspnea (ATS Gr.IV) onset 2 개월 전, recent agg. 10 일 전  Ex-smoker (1.5pack x 20yr, 13 년 전 부터 금연 )  사무직  2 개월 전 dry cough develop  1 개월 전 dyspnea develop, 빨리 걸으면 숨참  10 일 전 dyspnea agg. resting 시에도 sx.(+), local visit, CXR 이상 있 다 하여 7 일 전 지역 종합병원 입원  IM3 opd 예약 상태로 주말 사이 dyspnea agg. 되어 SMC ER visit  *PFT: FVC 1.48L(38%), FEV1 1.38L(44%) FEV1/FVC 93.3%, TLC 2.81L(45.5%) DLCO 19.4% severe restrictive pattern negative bronchodilator response  ABGA: %

Diffuse ground-glass opacity on the both lung, and reticular opacity on lower lung zone

Diffuse ground-glass opacity on the both lung, area of decreased attenuation suggesting air trapping and centrilobular nodules

Cellular chronic interstitial pneumonia, accentuated in peribronchiolar parenchyma

Combination of a cellular chronic interstitial pneumonia, accentuated in peribronchiolar parenchyma, ill-defined non-necrotizing granulomas

Combination of a cellular chronic interstitial pneumonia, accentuated in peribronchiolar parenchyma, ill-defined non-necrotizing granulomas (arrows)

ill-defined non-necrotizing granulomas (arrows) HYPERSENSITIVITY PNEUMONIA ( EXTRINSIC ALLERGIC ALVEOLITIS )