PMC10176247_01
Chest CT before and after each hospitalization. Before the first admission (A) and eight days after the admission (B). On the second admission (C) and 15 days after the second admission (D). On the third admission (E) and at the follow-up clinic visit one month after E (F).. A. Diffuse GGO with a mosaic pattern was noted.. B. There was an improvement in the GGO.. C. GGO reappeared in the lung field. Pericardial effusion was evident.. D. Both GGO and pericardial effusion had improved.. E. GGO and pericardial effusion reappeared and worsened.. F. There were improvements both in GGO and pericardial effusion.
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The GGO was diffusely distributed in all lobes without upper-lower or central-to-peripheral predominance (Fig. 1A). The CT (Fig. 1B) and spirometry (Fig. 3) findings also improved. CT and spirometry showed improvement (Figs. 1D and 3). Pericardial effusion also decreased with diuretics (Fig. 1D). CT confirmed the reappearance of GGO and pericardial effusion (Fig. 1E). His condition improved again with diuretics and hospitalization (Figs. 1F and 3).
Serial sections of a transbronchial lung biopsy specimen stained with Hematoxylin and Eosin (A) and Elastica van Gieson (B). The specimen appears crushed, but alveolar elastic fibers are visible in B. A mild increase in macrophages in the alveolar space and septa suggests mild inflammation. Gross inflammation with lymphocyte or neutrophil infiltration is not observed. Vascular congestion is difficult to assess with this specimen. No hemosiderin-laden macrophages, which are indicative of chronic pulmonary congestion, are found.
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Transbronchial lung biopsy revealed only a mildly inflamed interstitium with mild inflammatory cell infiltration (Fig. 2).
Spirometry before or on admission and after hospitalization. There was a significant improvement in forced vital capacity at each admission.
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CT and spirometry showed improvement (Figs. 1D and 3). His condition improved again with diuretics and hospitalization (Figs. 1F and 3).