PMC6080219_01
Chest CT and X-rays, patient age 27 years.
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A high-resolution computed tomographic scan of the chest showed diffuse interlobular septal thickening with several areas of bulla or large cysts, without bronchiectasis or significant fibrosis (Fig. 1).
A: Low magnification of the lower lobe shows temporal heterogeneity with dense pink areas representing fibrosis, intervening uninvolved areas (**) and small airways disease (SAD) (top right). B: High magnification demonstrates fibrosis (left lower) and relatively uninvolved areas (**) with fibroblastic foci (FF) separating the two. C: A high magnification on the Movat stain highlights the fibroblastic foci (FF) alongside fibrosis (yellow) and uninvolved lung (**). (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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Biopsy of the right lower lobe showed fibrosing and cellular interstitial pneumonitis with extensive peribronchiolar metaplasia, pleuritis, adhesions, and extensive fatty metaplasia (Fig. 2).