PMC6125794_01
Radiological course. Chest computed tomographic images showed bilateral peripheral non-septal plate-like opacities, reticulation, intra-lobular septal thickening, and peri-bronchovascular ground-glass opacities at the initial visit (A/B). Afterwards, the lesions had improved at 5 months after starting anti-inflammatory therapy (C/D).
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C, blood pressure 97/64 mmHg, pulse 75 bpm with regular rhythm, and oxygen saturation 94% on pulse oximetry. Chest computed tomography (CT) scan revealed bilateral non-septal plate-like opacity, ground-glass opacities, and intralobular septal thickening (Fig. 1A/B). We confirmed improvement of his respiratory symptoms and reduction of the disease extent of the ILD (Fig. 1C/D) and bronchial lesions (Fig. 2E) at 6 months after the start of the medical intervention.
Fiberoptic bronchoscopy findings showed white plaques on the bronchial mucosa in the trachea (A) and the right main bronchus (arrowhead) (B). Histological findings of plaque from the tracheal ulcer showed necrotizing bronchial inflammation at low-power (C) and high-power magnification (D) (hematoxylin and eosin stain). Bronchoscopy at 6 months after therapy showed disappearance of the tracheobronchial lesions (E).
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In addition, multiple lesions of white plaques on the bronchial mucosa were found in the trachea and bilateral main bronchi (Fig. 2A/B). The histopathology of these lesions revealed a necrotizing bronchial inflammation (Fig. 2C/D).