PMC8218619_01
Chest X-ray depicted no pathological findings-despite the patient's symptoms
of cough and hemoptysis.
10.1177_11795476211005821-fig1.jpg
PMC8218619_01_10.1177_11795476211005821-fig1.jpg
fig1-11795476211005821
Chest X-ray (Figure 1) depicted no pathological findings, whereas laboratory tests (Table 1) revealed neutrophilic leukocytosis [WBC = 13.4 K/muL (normal range: 3.8-10.5 K/muL) - neutrophils = 79.6% (normal range 45%-75%)].
CT scan of the thorax revealed multiple confluent ground glass and botryoid
nodules throughout the right lung, but also to a lesser extent in the left
lung. There is a thickening of the wall of the central bronchi of the right
lower lobe as well. Based on the reported history, the imaging findings are
primarily in favor of diffuse alveolar haemorrhage. An incidental finding of
an aneurysm, maximum diameter 4 cm, was also depicted in the ascending
aorta, without clinical denotation.
10.1177_11795476211005821-fig2.jpg
PMC8218619_01_10.1177_11795476211005821-fig2.jpg
fig2-11795476211005821
Computed Tomography (CT) scan of the thorax (Figure 2) revealed multiple bilateral ground glass opacities compatible with alveolar hemorrhage.
CT scan of the thorax 1 month later revealed resolution of the ground glass
opacities that had been depicted 1 month ago. The dimensions of the
ascending aorta were measured the same.
10.1177_11795476211005821-fig3.jpg
PMC8218619_01_10.1177_11795476211005821-fig3.jpg
fig3-11795476211005821
On the 4th hospitalization day, corticosteroid therapy was tapered to 32 mg of oral methylprednisolone and 7 days later the patient was discharged from the hospital as shown in timeline (Figure 3).
Symptoms and signs, diagnostic approach, therapeutic intervention, and
follow-up shown in timeline schedule.
10.1177_11795476211005821-fig4.jpg
PMC8218619_01_10.1177_11795476211005821-fig4.jpg
fig4-11795476211005821
High resolution chest tomography (HRCT) was performed (Figure 4), which revealed resolution of the ground glass opacities that had been depicted 1 month ago.