PMC4356040_01
High resolution computed tomography revealed air space consolidation intermingled groung glass opacities in the upper and middle lobes in the right lung (A: case 1) and bilateral patchy consolidation and diffuse small nodules (B: case 2).
gr1.jpg
PMC4356040_02_gr1.jpg
fig1
After 3 weeks, the opacities getting worse rapidly and HRCT revealed bilateral patchy consolidation and diffuse small nodules (Fig. 1B).
Case 1 (A) was diagnosed by transbronchial lung biopsy and case 2 (B) was by surgical lung biopsy. These specimens revealed the numerous fibrin balls, organizing loose connective tissues and hyperplasia of type II pneumocytes. But the accumulation of eosinophils, the formation of hyaline membrane and hemosiderin-laden macrophages were not visible (hematoxylin-eosin stain, original magnification x 200). Immunohistochemical stain with anti-hemeoxygenase (HO) -1 antibody to the affected lung demonstrated HO-1 overexpression in the macrophages within fibrin balls and type II pneumocytes around fibrin balls (original magnification x 200).
gr2.jpg
PMC4356040_02_gr2.jpg
fig2
Surgical lung biopsy (SLB) specimens revealed numerous fibrin balls and organization with type II pneumocytes hyperplasia without the presence of hyaline membranes, eosinophilic infiltrations and granulomas (Fig. 2B).
PMC4356040_02
High resolution computed tomography revealed air space consolidation intermingled groung glass opacities in the upper and middle lobes in the right lung (A: case 1) and bilateral patchy consolidation and diffuse small nodules (B: case 2).
gr1.jpg
PMC4356040_02_gr1.jpg
fig1
After 3 weeks, the opacities getting worse rapidly and HRCT revealed bilateral patchy consolidation and diffuse small nodules (Fig. 1B).
Case 1 (A) was diagnosed by transbronchial lung biopsy and case 2 (B) was by surgical lung biopsy. These specimens revealed the numerous fibrin balls, organizing loose connective tissues and hyperplasia of type II pneumocytes. But the accumulation of eosinophils, the formation of hyaline membrane and hemosiderin-laden macrophages were not visible (hematoxylin-eosin stain, original magnification x 200). Immunohistochemical stain with anti-hemeoxygenase (HO) -1 antibody to the affected lung demonstrated HO-1 overexpression in the macrophages within fibrin balls and type II pneumocytes around fibrin balls (original magnification x 200).
gr2.jpg
PMC4356040_02_gr2.jpg
fig2
Surgical lung biopsy (SLB) specimens revealed numerous fibrin balls and organization with type II pneumocytes hyperplasia without the presence of hyaline membranes, eosinophilic infiltrations and granulomas (Fig. 2B).