PMC6039750_01
(A) Chest posterioranterior (PA) X-ray showed normal findings 3 months before admission. (B) Chest PA obtained at admission showed air space consolidation in the right upper lobe. (C) Two months after admission, the chest PA was performed in the outpatient clinic. The consolidation lesion observed in the right upper lobe was slightly improved.
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When he was admitted, his chest X-ray showed a pattern of consolidation in the right upper lung field (Fig. 1). The consolidation lesion observed in the right upper lobe had slightly improved (Fig. 1).
(A) Chest computed tomography (CT) images acquired three weeks before admission, showing patchy air space consolidation in the right upper lobe. (B) The chest CT was re-performed at admission. It showed peribronchial distribution with peripheral segmental air-space consolidation in the right upper posterior segment and small ill-defined nodules. The air space consolidation in the right upper lung field was increased compared with previous images.
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The air space consolidation on right upper lung field was increased compared with previous study results (Fig. 2).
Photomicrograph after bronchoalveolar lavage shows numerous macrophages containing bright blue colored granular pigments in the cytoplasm. (Prussian blue stain, (A) x400, (B) x 1000).
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The intracellular iron particles were markedly positive upon Prussian blue staining (x 1000) (Fig. 3).
A computed tomography guided transthoracic needle biopsy specimen showed macrophage containing Prussian blue stain positive iron particles. (Prussian blue stain, x400).
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The biopsy specimen also showed alveolar, macrophage-containing, Prussian blue-positive iron particles in the alveolar space (Fig. 4).