PMC5548680_01
Chest radiography on admission (7 weeks after starting pirfenidone) showing bilateral reticular opacities and left pleural effusion.
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Chest radiography (Fig. 1) and computed tomography (CT) (Fig. 2) showed left pleural effusion, reticular opacities with traction bronchiectasis and honeycombing in the lower lobes.
Medical thoracoscopy revealed diffuse thickening with multiple translucent nodules (arrow) and adhesion on the parietal pleura and diaphragm.
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Medical thoracoscopy showed diffuse pleural thickening with multiple translucent nodules and adhesions in the parietal pleura and diaphragm (Fig. 3).
The pathological examination of the left parietal pleural biopsy specimen revealed the formation of lymphoid follicles and the massive infiltration of eosinophils (Hematoxylin and Eosin staining: a: x20, b: x100).
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A histopathological examination of the nodule in the diaphragm revealed lymphoid follicles and the massive infiltration of eosinophils, lymphocytes, and plasma cells, without cancer cells or granuloma (Fig. 4).