PMC4748756_01
Chest X-ray (a) and CT scan (b) on admission. a Chest X-ray revealed thickened lung marking in both lower lung fields. b Chest CT scan showed honeycombing, reticular and ground glass opacities in the lower lung fields (arrows).
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F1
Chest X-ray revealed thickened lung marking in both lower lung fields (fig. 1a). Chest CT scan showed honeycombing, reticular and ground glass opacities in the lower lung fields (fig. 1b).
Lung biopsy showed eosinophilia (arrows), lymphocyte and plasma cell infiltration and multiple eosinophil inflammation without granuloma formation.
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F2
Lung biopsy showed eosinophilia with vasculitis changes and granuloma formation (fig. 2).
Light microscopy and immunofluorescent findings on renal biopsy. The biopsy specimen contained 6 glomeruli, 2 of which with gomerulosclerosis. Another 2 showed segmental necrosis (arrows). Two granuloma-like structures were seen in situ. Diffuse chronic inflammatory cell infiltration with predominant lymphocytes and plasma cells was observed in mesenchyma.
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F3
Percutaneous renal biopsy was performed and immunofluorescence microscopy disclosed linear staining of glomerular capillary basement membrane for IgG and C3, diagnostic for anti-GBM disease (fig. 3).
Chest CT scan showing anterosuperior mediastinal mass before (a; arrow) and after (b; arrow) treatment. a The size of the anterosuperior mediastinal mass was 3.5 x 1.9 cm with CT 5 HU. b The same mass was diminished to 1.2 x 1.0 cm with CT 16 HU.
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F4
Meanwhile, the anterosuperior mediastinal mass was remarkably diminished without thymectomy intervention (fig. 4).