PMC10122576_01
Admission noncontrast chest CT demonstrating diffuse confluent ground-glass opacities in all five lobes with prominent subpleural sparing.
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Subsequently, a chest computed tomography (CT) was significant for diffuse confluent ground-glass opacities in all five lobes with prominent subpleural sparing (Figure 1).
Bronchoalveolar lavage serial aliquots. Aspirate marked 1 correlates with the first aliquot with ascending numbers denoting sequentially taken aliquots. Findings demonstrate progressive blood-tinged fluid consistent with alveolar hemorrhage.
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The aspirated fluid from the lavage was pink-tinged, and a deepening of the pink color was noticed with subsequent aliquots (Figure 2).
A glomerulus is involved by fibrocellular crescent (black arrow) occupying most of the Bowman space of the glomerulus. The glomerular capillary loops are collapsed and corrugated (Periodic Acid-Schiff, original magnification x40).
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The patient subsequently underwent a renal biopsy which exhibited a picture of pauci-immune necrotizing crescentic glomerulonephritis (Figures 3 and 4).
Another glomerulus showing a segmental fibrinoid necrosis (black arrow) causing obliteration and break of capillary loops (Methenamine silver stain, original magnification x40).
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The patient subsequently underwent a renal biopsy which exhibited a picture of pauci-immune necrotizing crescentic glomerulonephritis (Figures 3 and 4).