PMC4531735_01
Gottron's papules of the patient
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Physical examination showed violaceous erythema of the face, erythematous macules on bony prominences as interphalangeal joints (Gottron's papules), on the neck, chest and back(Figure 1) and proximal muscle weakness with normal distal muscle strength of all four extremities.
High resolution CT showed multifocal airspace consolidations in subpleural location of both basal lungs.. Clinical spectrum of polymyositis/dermatomyositis)
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High resolution CT showed multifocal airspace consolidations in the subpleural location of both basal lungs(Figure 2), and bronchoalveolar lavage showed WBC of 7.2 x 106; macrophage of 60% (normal 85%), lymphocyte of 12% (normal 7-12%), neutrophil of 28% (normal 1-2%).
Lung biopsy revealed the respiratory bronchiole and adjacent alveolar duct filled with fibroblastic plugs (Masson's body) and relatively spared interstitium (Masson-Trichrome, x100).
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The skin biopsy of the forehead showed superficial perivascular lymphocytic infiltration, and thoracoscopic lung biopsy revealed the respiratory bronchiole and adjacent alveolar duct filled with fibroblastic plugs(Masson's body) and relatively spared interstitium(Figure 3).