PMC5337467_01
Imaging and pathological findings of Patient 1. A) Chest radiograph showing patchy consolidations in both lungs. B) Chest computed tomography showing patchy, peribronchial consolidations with air bronchograms and ground-glass opacities in both lungs. C) Microphotographs of a specimen obtained via transbronchial lung biopsy showing lymphocytic alveolitis and plugs of granulation tissue within airspaces (Hematoxylin and Eosin staining; original magnification, x100). D) Chest radiograph obtained after 10 months of follow-up showing almost complete resolution of the consolidations in both lungs.
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Chest roentgenography (Fig. 1A) and computed tomography (Fig. 1B) showed patchy, peribronchial consolidations with air bronchograms and ground-glass opacities without pleural effusion in both lungs. Transbronchial lung biopsy revealed lymphocytic alveolitis and granulation tissue plugs within airspaces, suggesting organizing pneumonia (Fig. 1C). The patient remains healthy with no further symptoms or radiographic abnormalities (Fig. 1D), and she did not receive the annual influenza vaccine the following year.
PMC5337467_02
Imaging and pathological findings of Patient 2. A) Chest radiograph showing predominantly basilar consolidations in both lungs. B) Chest computed tomography scans showing peripheral, predominantly basilar, and partially subpleural ground-glass opacities and consolidations without honeycomb changes in both lungs. C) Microphotographs of a specimen obtained via transbronchial lung biopsy showing lymphocytic alveolitis and scattered plugs of granulation tissue (Hematoxylin and Eosin staining; original magnification, x100). D) Chest radiograph obtained after 13 months of follow-up showing almost complete resolution of the consolidations in both lungs.
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CRP, 2.95 mg/dL; ferritin, 701.1 ng/mL; sIL-2R, 670 U/mL; KL-6, 2,276 U/mL; SP-D, 160.6 ng/mL; and SP-A, 152.9 ng/mL. Chest roentgenography (Fig. 2A) and computed tomography (Fig. 2B) showed peripheral, predominantly basilar, and partially subpleural ground-glass opacities and consolidations without honeycomb changes in both lungs. Transbronchial lung biopsy confirmed lymphocytic alveolitis and scattered granulation tissue plugs within airspaces (Fig. 2C), with alveolar epithelial shedding and regenerative hyperplastic epithelia, suggesting organizing pneumonia with alveolar epithelial injury. The patient remains healthy with no further symptoms or radiographic abnormalities (Fig. 2D), and he did not get the annual influenza vaccine the following year.