PMC9329585_01
Evolution of the computed tomography (CT) findings of the patient. (A) Scattered solid nodules in both lungs, with fibrous stripe shadow in the medial middle lobe of the right lung and slight enlargement in the left hilum; (B) patchy areas of ground glass opacities (GGO), consolidation in the double lungs scattered all over both lungs and slightly enlarged mediastinal lymph nodes; (C) consolidation and GGO in both lungs decreased compared with the previous one; (D) only a small amount of GGO and fibrous stripe shadow.
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F1
Chest computed tomography (CT) revealed scattered solid nodules in both lungs, with a fibrous striped shadow in the medial segment of the middle lobe of the right lung and slight enlargement in the left hilum (Figure 1A). Contrast-enhanced chest CT revealed patchy areas of ground-glass opacities (GGO) and consolidation in both lungs scattered all over and with slightly enlarged mediastinal lymph nodes (Figure 1B). On day 21 after steroid use, her chest radiograph (Figure 1C) showed that the consolidation was less than the previous. On day 41 after steroid use, her symptoms and chest radiograph (Figure 1D) were indicative of a significant improvement, with complete resolution of pulmonary symptoms.
Evolution of the chest X-ray of the patient. (A) Extensive consolidation of both lungs; (B) consolidation of both lungs decreased significantly.
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F2
On ICU day 2, her respiratory status continued to decline, and bedside chest radiographs (Figure 2A) showed progression of bilateral infiltrates. Bedside chest radiographs showed consolidation of both lungs decreased significantly on ICU day 10 (Figure 2B).
Histological patterns of the patient's lung tissue. (A) Hematoxylin-eosin stain revealed the presence of fibroblasts intermixed with loose connective tissue and collagen in the alveoli and the distal bronchioles. (B) Masson stain showed a mass of blue collagen fibers stained with aniline blue.
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F3
Three specimens were obtained from the outer and posterior basal segments of the lower lobe of the left lung, and histological examination revealed fibroblasts intermixed with loose connective tissue and collagen in the alveoli and the distal bronchioles (Figures 3A,B).