PMC7248675_01
A, B, C. Thoracic CT scan showing few ground glass infiltrates predominantly in the upper lobes, without evidence of lymph node enlargement, nodules, pulmonary masses or pleural involvement. D. Aspect of the airway during bronchoscopy, which is of normal characteristics.
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This scan showed a mosaic pattern of disseminated attenuation in both lungs with foci of ground glass infiltrates (Fig. 1 A, B, C). In the bronchoscopy, the aspect of the airway was normal, without endobronchial lesions or bleeding (Fig. 1 D), washing cytology showed a predominance of lymphocytes in 46% without the presence of malignant cells.
A, B. H & E stain shows a pulmonary parenchyma with conserved architecture and the presence of rounded granulomas composed of epithelioid macrophages, giant multinucleated cells and scarce lymphoplasmacytic infiltrate. No central necrosis is identified, and no microorganisms are observed with BK, PAS, Mucicarmin and GMS special stains. C, D. Thoracic CT scan with a decrease in the infiltrates and the mosaic attenuation, presence of mediastinal lymph node enlargement in the low precarinal area.
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A new high-resolution thoracic CT scan showed a notable decrease in the mosaic attenuation (Fig. 2 C, D).