PMC7363707_01
(a) Chest X-ray and (b) chest CT show bilateral diffuse ground-glass opacities and infiltration shadows.
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Chest X-ray revealed bilateral infiltrates (Fig. 1a) and respiratory failure needing oxygen therapy was observed. Chest computed tomography (CT) revealed bilateral diffuse ground-glass opacities (Fig. 1b).
(a) The alveoli area shows patchy infiltration of inflammatory cells and alveolitis associated with lymphocytes (H&E staining, low-power field). The area around the central bronchial walls shows the infiltration of abundant eosinophils (H&E staining, (b) low-power field and (c) high-power field). Arrows indicate eosinophils.
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Histologic examination of transbronchial lung biopsy specimens revealed patchy infiltration of inflammatory cells and alveolar infiltration associated with lymphocytes (Fig. 2a). HP induced by T. asahii was diagnosed, although other antigens might also be involved in the pathogenesis based on the results of precipitation antibody reaction tests. However, there was an infiltration of abundant eosinophils around the central bronchial walls (Fig. 2b and c), which is untypical of HP.