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Chest X ray: bilateral alveolar opacities
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A lung X ray showed bilateral alveolar opacities (Figure 1).
CT scan (lung windowing): a & b) bilateral lung consolidations and ground glass opacities with bronchial distortion; c & d) CT scan at 2 years: partial regression of lung consolidations and ground glass opacities and increase of distortion signs and cavities appearance
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Chest computed tomography (CT) showed diffuse ground-glass opacities (Figure 2A, Figure 2B) and mediastinal lymphadenopathies. ARF. An enhanced CT scan performed showed further deterioration of pulmonary parenchyma (Figure 2C, Figure 2D) and pulmonary embolism with fatal issue.
Microscopic exam: a) epitheloid granuloma; b) incorporation of hyaline membranes into the alveolar septa (arrow) (HE x 400); c) trichrom stain highlighting the honeycomb aspect (x 250)
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There were no mineral particles observed with polarized light (Figure 3).