PMC9121459_01
Initial chest CT showing multifocal consolidation with reversed halo sign (arrowheads)
involving the right lower and left upper and lower lobes. These findings correspond to
those of cryptogenic organizing pneumonia, a subtype of subacute interstitial
pneumonia.. Abbreviation: CT, computed tomography.
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Initial chest computed tomography demonstrated multifocal consolidations with reversed halo sign involving both lungs (Figure 1).
Magnetic resonance imaging of the spinal cord showing longitudinally extensive T2
hyperintensity at the thoracic level. (A) T2-weighted sagittal image showing multiple
longitudinally extensive hyperintense lesions at the T3-8 levels. (B) Axial T2-weighted
image showing a hyperintense lesion at central T5 spinal cord.
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Cord swelling was not observed (Figure 2).
Fine needle biopsy of the consolidated lung lesion in the right lower lobe
demonstrating interstitial fibrosis with mild inflammatory cell infiltration. (H&E
stain x 200).
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To rule out cancer, PCNA was performed in the right lower lobe and no tumor cells were present although interstitial fibrosis with mild inflammatory cell infiltration was observed. (Figure 3) Oral steroid (60 mg) was tapered and 2 g of mycophenolate mofetil was added.
Chest radiograph showing interval changes. (A) Chest radiograph showing new multifocal
consolidations (arrowhead) involving the right upper and lower lung zones. (B) Chest
radiograph after steroid treatment showing resolution of consolidations.
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After 2 weeks of treatment, the neuropathic pain resolved considerably (she had a VAS score of 2-3) along with the multiple lung consolidations (Figure 4).