PMC5108743_01
CECT of the Chest revealing. a Extensive right upper lobe consolidation, bronchocentric consolidation with air bronchogram, band like and peripheral consolidation and b the "reversed halo" sign of focal perilobular consolidation with central ground-glass opacities suggestive of organizing pneumonia. c, d CECT of the Chest before discharge revealing marked resolution of the organizing pneumonia after cessation of transtuzumab
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Fig1
Scan of the chest and abdomen revealed dense extensive right upper and left lower lobe para-mediastinal consolidation along with smaller, bilateral patches and air bronchograms consistent with a diagnosis of organizing pneumonia (Fig. 1a, b). Septal lines and interstitial opacities in the mid lower zones suggested lymphangitis. The CECT scan of the chest done at discharge (Fig. 1c, d) revealed marked reduction in the organizing pneumonia and interstitial infiltrates.
H&E staining 200x photomicrographs showing a focal intra-alveolar fibrin deposition with patchy reactive type II pneumocyte hyperplasia and focal organising pneumonia; b focal infiltrate of polygonal cells forming tubular like structures; c Described infiltrate of polygonal cells positive for GATA3 consistent with metastatic breast carcinoma
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Fig2
The biopsy revealed patchy intra-alveolar haemorrhage and fibrin deposition with collections of intra-alveolar foamy macrophages, patchy reactive type II pneumocyte hyperplasia and focal organizing pneumonia (Fig. 2a). There was also a localised interstitial infiltrate of polygonal cells forming tubular structures and a small ill-defined sheet (Fig. 2b).
PMC5108743_02