PMC8390688_01
High resolution computed tomography (HRCT) in case 1 showed diffuse ground-glass opacity (GGO) and centrilobular nodules at the initial visit (A), (B). (B) Enlarged image of the left upper lobe. The patient improved after steroid pulse treatment (C). Chest computed tomography (CT) after the second steroid treatment (D)showed further improvement of the shadow.
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His fever and abnormal shadow improved, without maintenance of steroid therapy (Fig. 1C). Thereafter, his chest CT showed complete resolution of the shadow (Fig. 1D).
A transbronchial lung biopsy of case 1 showed fibrocellular alveolitis (arrowheads) and accumulation of histiocytes (arrows). (A. Hematoxylin eosin stain, B. Elastica van Gieson stain, high power field).
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TBLB showed fibro-cellular alveolitis and accumulation of histiocytes without granulomas (Fig. 2).
PMC8390688_02
CT in case 2. Diffuse ground-glass opacity and centrilobular nodules were observed at the initial visit (A), these increased just before steroid treatment (B), and disappeared after steroid treatment (C).
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C) and gradually worsening dyspnea, 7 months after the chemotherapy had started. Chest CT showed diffuse GGO and centrilobular nodules (Fig. 3 A), suggesting a typical non-fibrotic HP pattern. Chest CT revealed a more increased GGO than the previous chest CT (Fig. 3 B). Her symptoms, clinical findings, and radiographic findings (Fig. 3C) were remarkably improved.
PMC8390688_03
HRCT in case 3 showed bilateral patchy ground-glass opacity and centrilobular nodules at the onset (A), (B). (B) indicates representative abnormal shadow in the right upper lobe on the same CT of (A). His shadow improved after steroid pulse treatment (C).
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Chest CT revealed bilateral patchy GGO and ill-defined centrilobular nodules (Fig. 4A and B). After steroids were started, symptoms, laboratory data, and chest CT findings all improved (Fig. 4C).