PMC10024043_01
High-resolution chest CT-scan showing thickening of inter and intralobular septa associated with grounded glass opacities predominantly in lung bases. Multiple foci of multilobes consolidation areas, bronchiolectasias without evidence of honeycomb, suggestive of unspecified interstitial pneumonia.
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Chest CT-scan showed thickening of inter and intralobular septa, grounded glass areas predominantly in the bases with multiple consolidation areas (Fig. 1).
Bronchoscopy showing pale mucosa, without evidence of endobronchial lesions or abnormal secretions.
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Bronchoscopy with transbronchial biopsies was performed along with bronchoalveolar lavage (Fig. 2).
A. H&E 10x (low magnification). Bronchial mucosa shows no abnormalities in the lining epithelium. Pulmonary parenchyma with alteration of the architecture is observed due to the presence of collagen foci and young fibroblasts that in some places protrude towards the alveolar spaces. B. H&E 20x. At higher magnification, fibroblasts with protrusion towards the alveoli become more evident. In some alveolar septa there is lymphoplasmacytic cellularity without acute inflammation. C. Movat 10x (low magnification). Fibroblastic foci are identified, causing thickening of the alveolar septa. D. Movat 20x. At higher magnification, the alternation between green and yellow hue of young fibroblasts is observed. (For interpretation of the references to colour in this figure legend, the reader is referred to the Web version of this article.)
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This was considered compatible with organizing pneumonia (Fig. 3).