PMC5922339_01
Case 1: Transverse unenhanced computed tomography (CT) images (A and B) demonstrate dense peribronchial consolidation (thin arrows) with air bronchograms (curved arrows); note the rim of consolidation (wide arrow) peripheral to a focus of ground-glass opacity, reminiscent of the "reverse halo" sign seen in organising pneumonia, and small bilateral effusions are present (arrowheads). Case 2: Transverse section (C) shows several foci of peribronchial and perilobular consolidations (arrows) and ground-glass opacity (arrowheads), and small pleural effusions are present. Case 3: Transverse high-resolution computed tomography (HRCT) image (D) demonstrates patchy peribronchial ground-glass opacity with superimposed reticulation and mild traction bronchiectasis (arrows). Case 4: Transverse HRCT images (E and F) show extensive, patchy ground-glass opacity, traction bronchiectasis (arrows in E), superimposed reticulation with peripheral and peribronchial consolation (F), and interlobular septal thickening (F).
41479_2016_6010067_Fig1.jpg
PMC5922339_04_41479_2016_6010067_Fig1.jpg
Fig1
Three months later she noted persistent mild symptoms of cough and dyspnoea on exertion, associated with new persistent infiltrates on imaging (Figure 1, E and F), accompanied by a significant decline in FEV1 and oxyhaemoglobin desaturation with activity.
Case 1: Transbronchial biopsy shows lung parenchyma with intra-alveolar fibrin aggregates or "balls" (arrows) with mild mononuclear interstitial infiltrate (A: Haematoxylin-eosin stain [H/E], 100x magnification), without evidence of cellular rejection given the lack of perivascular or bronchial mucosal infiltrates (B: H/E, 200x magnification). Case 2: Surgical lung biopsy shows intraalveolar fibrin aggregates (arrows) and mild fibroblastic proliferation with minimal mononuclear inflammatory cell infiltrate (C: H/E 100x magnification; D: H/E 200x magnification). Case 3: Autopsy specimen shows intra-alveolar fibrin aggregates (arrows) (E: H/E 100x magnification; F: H/E 200x magnification).
41479_2016_6010067_Fig2.jpg
PMC5922339_03_41479_2016_6010067_Fig2.jpg
Fig2
AFOP was observed in lung specimens examined at autopsy (Figure 2, E and F).
PMC5922339_02
Case 1: Transverse unenhanced computed tomography (CT) images (A and B) demonstrate dense peribronchial consolidation (thin arrows) with air bronchograms (curved arrows); note the rim of consolidation (wide arrow) peripheral to a focus of ground-glass opacity, reminiscent of the "reverse halo" sign seen in organising pneumonia, and small bilateral effusions are present (arrowheads). Case 2: Transverse section (C) shows several foci of peribronchial and perilobular consolidations (arrows) and ground-glass opacity (arrowheads), and small pleural effusions are present. Case 3: Transverse high-resolution computed tomography (HRCT) image (D) demonstrates patchy peribronchial ground-glass opacity with superimposed reticulation and mild traction bronchiectasis (arrows). Case 4: Transverse HRCT images (E and F) show extensive, patchy ground-glass opacity, traction bronchiectasis (arrows in E), superimposed reticulation with peripheral and peribronchial consolation (F), and interlobular septal thickening (F).
41479_2016_6010067_Fig1.jpg
PMC5922339_04_41479_2016_6010067_Fig1.jpg
Fig1
Three months later she noted persistent mild symptoms of cough and dyspnoea on exertion, associated with new persistent infiltrates on imaging (Figure 1, E and F), accompanied by a significant decline in FEV1 and oxyhaemoglobin desaturation with activity.
Case 1: Transbronchial biopsy shows lung parenchyma with intra-alveolar fibrin aggregates or "balls" (arrows) with mild mononuclear interstitial infiltrate (A: Haematoxylin-eosin stain [H/E], 100x magnification), without evidence of cellular rejection given the lack of perivascular or bronchial mucosal infiltrates (B: H/E, 200x magnification). Case 2: Surgical lung biopsy shows intraalveolar fibrin aggregates (arrows) and mild fibroblastic proliferation with minimal mononuclear inflammatory cell infiltrate (C: H/E 100x magnification; D: H/E 200x magnification). Case 3: Autopsy specimen shows intra-alveolar fibrin aggregates (arrows) (E: H/E 100x magnification; F: H/E 200x magnification).
41479_2016_6010067_Fig2.jpg
PMC5922339_03_41479_2016_6010067_Fig2.jpg
Fig2
AFOP was observed in lung specimens examined at autopsy (Figure 2, E and F).
PMC5922339_03
Case 1: Transverse unenhanced computed tomography (CT) images (A and B) demonstrate dense peribronchial consolidation (thin arrows) with air bronchograms (curved arrows); note the rim of consolidation (wide arrow) peripheral to a focus of ground-glass opacity, reminiscent of the "reverse halo" sign seen in organising pneumonia, and small bilateral effusions are present (arrowheads). Case 2: Transverse section (C) shows several foci of peribronchial and perilobular consolidations (arrows) and ground-glass opacity (arrowheads), and small pleural effusions are present. Case 3: Transverse high-resolution computed tomography (HRCT) image (D) demonstrates patchy peribronchial ground-glass opacity with superimposed reticulation and mild traction bronchiectasis (arrows). Case 4: Transverse HRCT images (E and F) show extensive, patchy ground-glass opacity, traction bronchiectasis (arrows in E), superimposed reticulation with peripheral and peribronchial consolation (F), and interlobular septal thickening (F).
41479_2016_6010067_Fig1.jpg
PMC5922339_04_41479_2016_6010067_Fig1.jpg
Fig1
Three months later she noted persistent mild symptoms of cough and dyspnoea on exertion, associated with new persistent infiltrates on imaging (Figure 1, E and F), accompanied by a significant decline in FEV1 and oxyhaemoglobin desaturation with activity.
Case 1: Transbronchial biopsy shows lung parenchyma with intra-alveolar fibrin aggregates or "balls" (arrows) with mild mononuclear interstitial infiltrate (A: Haematoxylin-eosin stain [H/E], 100x magnification), without evidence of cellular rejection given the lack of perivascular or bronchial mucosal infiltrates (B: H/E, 200x magnification). Case 2: Surgical lung biopsy shows intraalveolar fibrin aggregates (arrows) and mild fibroblastic proliferation with minimal mononuclear inflammatory cell infiltrate (C: H/E 100x magnification; D: H/E 200x magnification). Case 3: Autopsy specimen shows intra-alveolar fibrin aggregates (arrows) (E: H/E 100x magnification; F: H/E 200x magnification).
41479_2016_6010067_Fig2.jpg
PMC5922339_03_41479_2016_6010067_Fig2.jpg
Fig2
AFOP was observed in lung specimens examined at autopsy (Figure 2, E and F).
PMC5922339_04
Case 1: Transverse unenhanced computed tomography (CT) images (A and B) demonstrate dense peribronchial consolidation (thin arrows) with air bronchograms (curved arrows); note the rim of consolidation (wide arrow) peripheral to a focus of ground-glass opacity, reminiscent of the "reverse halo" sign seen in organising pneumonia, and small bilateral effusions are present (arrowheads). Case 2: Transverse section (C) shows several foci of peribronchial and perilobular consolidations (arrows) and ground-glass opacity (arrowheads), and small pleural effusions are present. Case 3: Transverse high-resolution computed tomography (HRCT) image (D) demonstrates patchy peribronchial ground-glass opacity with superimposed reticulation and mild traction bronchiectasis (arrows). Case 4: Transverse HRCT images (E and F) show extensive, patchy ground-glass opacity, traction bronchiectasis (arrows in E), superimposed reticulation with peripheral and peribronchial consolation (F), and interlobular septal thickening (F).
41479_2016_6010067_Fig1.jpg
PMC5922339_04_41479_2016_6010067_Fig1.jpg
Fig1
Three months later she noted persistent mild symptoms of cough and dyspnoea on exertion, associated with new persistent infiltrates on imaging (Figure 1, E and F), accompanied by a significant decline in FEV1 and oxyhaemoglobin desaturation with activity.
PMC5922339_05
PMC5922339_06