PMC7313101_01
Case 1 CXR on presentation.
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Chest radiograph (CXR) revealed diffuse interstitial prominence (Figure 1).
Case 1 chest CT scan on presentation (axial view).
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A subsequent computed tomography (CT) scan of the chest revealed extensive symmetric ground-glass opacities in all lobes with interlobular septal thickening and subpleural sparing (Figures 2 and 3).
Case 1 chest CT scan on presentation (coronal view).
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A subsequent computed tomography (CT) scan of the chest revealed extensive symmetric ground-glass opacities in all lobes with interlobular septal thickening and subpleural sparing (Figures 2 and 3).
Case 1 transbronchial biopsy of upper division of left upper lobe with benign bronchial mucosa.
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A transbronchial tissue biopsy of the left upper lobe (upper division and lingula) (Figures 4 and 5) revealed benign bronchial mucosa without significant pathologic abnormality.
Case 1 transbronchial biopsy of left lingula with benign bronchial mucosa.
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A transbronchial tissue biopsy of the left upper lobe (upper division and lingula) (Figures 4 and 5) revealed benign bronchial mucosa without significant pathologic abnormality.
PMC7313101_02
Case 2 CXR on presentation.
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CXR on admission showed patchy alveolar opacities in the mid and lower lungs bilaterally (Figure 6).
Case 2 chest CT scan on presentation (axial view).
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CT chest demonstrated basal-predominant bilateral ground-glass opacities with subpleural sparing, in addition to pneumomediastinum and slightly prominent bilateral hilar lymph nodes (Figures 7 and 8).
Case 2 chest CT scan on presentation (coronal view).
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CT chest demonstrated basal-predominant bilateral ground-glass opacities with subpleural sparing, in addition to pneumomediastinum and slightly prominent bilateral hilar lymph nodes (Figures 7 and 8).
Case 2 bronchioalveolar lavage (BAL) of right lower lobe. Macrophages (red arrow) and neutrophils (yellow arrows).
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BAL of the right lower lobe revealed macrophages with neutrophils and lymphocytes (Figure 9).
Case 2 transbronchial biopsy of right lower lobe. Macrophages containing blackish brown pigmented particles (red arrows).
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A transbronchial tissue biopsy of the right lower lobe showed an acute fibrinous and organizing pneumonia pattern with no prominent eosinophils, granulomas, or malignancy (Figures 10-13).
Case 2 transbronchial biopsy of right lower lobe with multiple neutrophils.
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A transbronchial tissue biopsy of the right lower lobe showed an acute fibrinous and organizing pneumonia pattern with no prominent eosinophils, granulomas, or malignancy (Figures 10-13).
Case 2 transbronchial biopsy of right lower lobe. Eosinophilic fibrin exudate between cells, typical for pneumonia.
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A transbronchial tissue biopsy of the right lower lobe showed an acute fibrinous and organizing pneumonia pattern with no prominent eosinophils, granulomas, or malignancy (Figures 10-13).
Case 2 transbronchial biopsy. Macrophages (red arrows) and neutrophils (yellow arrows) in a background of exudative material.
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A transbronchial tissue biopsy of the right lower lobe showed an acute fibrinous and organizing pneumonia pattern with no prominent eosinophils, granulomas, or malignancy (Figures 10-13).
Case 2 chest CT scan 6 weeks post discharge (axial view).
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Repeat chest high-resolution CT (HRCT) at that time showed remarkable improvement in the aeration of his lungs and resolution of the bilateral ground-glass opacities (Figures 14 and 15).
Case 2 chest CT scan 6 weeks post discharge (coronal view).
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Repeat chest high-resolution CT (HRCT) at that time showed remarkable improvement in the aeration of his lungs and resolution of the bilateral ground-glass opacities (Figures 14 and 15).