PMC6031207_01
Chest X-ray showing bilateral interstitial infiltrates.
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Chest X-ray showed bilateral interstitial infiltrates (Figure 1).
HRCT chest showing peripherally based patchy, subsegmental lesions of the upper lobe and left lower lobe.
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High-resolution computed tomography (HRCT) chest showed peripherally based patchy, subsegmental lesions of the upper lobe and left lower lobe (Figures 2 and 3).
Low-power examination shows plugs of granulation tissue in bronchioles, alveolar ducts, and alveoli.
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Transbronchial lung biopsy was performed, and histology (Figures 4 and 5) showed air space consolidation with fibrinous exudation and polymorph and macrophage infiltration, along with polypoidal proteinous layer in the alveolar spaces composed of granulation tissue, with alveolar septa showing moderately dense chronic inflammatory infiltrates (Masson bodies), all were suggestive of cryptogenic organizing pneumonia (BOOP).
High-power examination shows Masson bodies that are rounded nodules of granulation tissue in alveolar spaces.
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Transbronchial lung biopsy was performed, and histology (Figures 4 and 5) showed air space consolidation with fibrinous exudation and polymorph and macrophage infiltration, along with polypoidal proteinous layer in the alveolar spaces composed of granulation tissue, with alveolar septa showing moderately dense chronic inflammatory infiltrates (Masson bodies), all were suggestive of cryptogenic organizing pneumonia (BOOP).
Chest X-ray showing clearance of bilateral interstitial infiltrates.
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The patient was treated with systemic steroids to which the patient responded dramatically with a clinical and significant radiological clearance (Figure 6) and a decrease in serum ACE to normal.
HRCT showing recurrence of bilateral patchy lesions in different zones.
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Chest radiograph and HRCT (Figure 7) showed recurrence of bilateral patchy lesions but in different zones of the lung.