PMC9381257_01
Admission chest radiograph demonstrates bilateral ill-defined opacities with mid and lower lung predominance.
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Chest radiography on admission showed bilateral basilar interstitial infiltrates and confluent consolidations (Figure 1).
Axial high-resolution CT demonstrates extensive bilateral peribronchovascular consolidations with air bronchograms, as well as scattered small nodular opacities.
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These consolidations did not spare the pleural space, and there were no traction bronchiectasis, fibrotic changes, or pleural effusions (Figures 2 and 3).
Coronal high-resolution CT image demonstrates extensive bilateral peribronchovascular consolidations with air bronchograms, as well as scattered small nodular opacities.
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These consolidations did not spare the pleural space, and there were no traction bronchiectasis, fibrotic changes, or pleural effusions (Figures 2 and 3).
Photomicrograph of transbronchial biopsy showing mild lymphocytic alveolar infiltrates (hematoxylin and eosin 200x).
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The transbronchial biopsies showed a mild interstitial pneumonia with minimal interstitial fibrosis (Figure 4).
(a) Photomicrograph of the wedge biopsy from the lower lobe showing interstitial lymphocytic alveolar infiltrates and adjacent interstitial fibrosis and peribronchiolar metaplasia (hematoxylin and eosin 20x). (b) The lower lobe wedge biopsy also showed areas with mild, diffuse interstitial fibrosis characteristic of fibrotic nonspecific interstitial pneumonia (NSIP) pattern of fibrosis (hematoxylin and eosin 20x). (c) The wedge biopsies showed only focal areas of organizing pneumonia with early intraalveolar fibrosis involving less than 10% of the tissues (hematoxylin and eosin 20x). (d) Foci of organizing pneumonia (hematoxylin and eosin 20x).
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Both wedge lung biopsies showed a diffuse chronic interstitial pneumonia with scattered lymphoid infiltrates of alveolar spaces and mild interstitial fibrosis (Figures 5(a) and 5(b)). Focal areas of organizing pneumonia and subpleural foci of peribronchiolar metaplasia with microscopic honeycombing were also present (Figures 5(c) and 5(d)).
Isolated fibroblastic foci (hematoxylin and eosin 100x).
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There was a scattered fibroblastic foci (Figure 6).