PMC6409392_01
Chest X-ray images: (A) March 2016, (B) January 2018, (C) April 2018, (D) October 2018.
gr1.jpg
PMC6409392_01_gr1.jpg
fig1
At that time, he was asymptomatic, had normal pulmonary function test results [forced vital capacity (FVC), 3.14 L (100%); forced expiratory volume in 1 s (FEV1), 2.72 L (125%); FEV1/FVC ratio, 87%], and SpO2 level of 96% at rest; however, a chest radiograph and computed tomography (CT) scan showed a basal and peripheral-dominant reticular abnormality without obvious honeycombing (Fig. 1, Fig. 2, Fig. 3A and B). His pulmonary function had markedly dropped to an FVC of 2.18 L (71%), and a chest radiograph showed a remarkably reduced lung volume with a peripheral-dominant reticular abnormality and ground-glass opacity (Fig. 1B). At 3 months after beginning nintedanib administration, a follow-up chest radiograph (Fig. 1C) and CT scan (Fig. 2C) showed partial improvement of the ground-glass opacities and a slight increase in the FVC (2.30 L, 75%) (Table 1). The 9-month follow-up chest radiograph, CT scan (Fig. 1, Fig. 2D), and levels of KL-6 and
CT scan images in March 2016: (A) Coronal image, (B) Sagittal image; High-resolution CT (HRCT) scan images in January 2018:(C) Axial images of right basal lung (top) and left basal lung (bottom).
gr3.jpg
PMC6409392_01_gr3.jpg
fig3
At that time, he was asymptomatic, had normal pulmonary function test results [forced vital capacity (FVC), 3.14 L (100%); forced expiratory volume in 1 s (FEV1), 2.72 L (125%); FEV1/FVC ratio, 87%], and SpO2 level of 96% at rest; however, a chest radiograph and computed tomography (CT) scan showed a basal and peripheral-dominant reticular abnormality without obvious honeycombing (Fig. 1, Fig. 2, Fig. 3A and B). A high-resolution CT (HRCT) scan showed basal- and peripheral-dominant honeycombing (Fig. 3C) and diffuse ground-glass opacities in all lung fields (Fig. 2B).