PMC4976608_01
a. Chest radiograph of case 1. b. Upper lung fields of chest CT in case 1. c. TBLB specimen stained with hematoxylin and eosin (HE) in case 1, Scale bar = 500mu. d. TBLB specimen stained with Elastica van Gieson (EVG) in case 1, Scale bar = 500mu.
gr1.jpg
PMC4976608_01_gr1.jpg
fig1
Ten years later, upper lung fibrosis had worsened with markedly increased hilar opacities (Fig. 1a). A chest computed tomography (CT) taken at our hospital showed a flattened chest cage and subpleural consolidations with traction bronchiectasis located in the bilateral upper lung fields (Fig. 1b). The EVG specimen revealed dense elastosis just beneath the subepithelial reticular basement membrane of the peripheral airway (Fig. 1c, d).
PMC4976608_02
a. Chest radiograph of case 2. b. Upper lung fields of chest CT in case 2. c. TBLB specimen (HE) in case 2, Scale bar = 1mm. d. TBLB specimen (EVG) in case 2, Scale bar = 1mm.
gr2.jpg
PMC4976608_02_gr2.jpg
fig2
A chest radiograph showed upper lobe-dominant fibrotic opacities with elevated hilar opacities (Fig. 2a). Chest CT showed subpleural consolidations with traction bronchiectasis and bilateral apical cysts (Fig. 2b). However, the histological specimen stained with EVG revealed dense aggregates of elastic fibers that were associated with intra-alveolar fibrosis (Fig. 2c, d).