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Case Reports
. 2021 Feb 24;16(5):1019-1022.
doi: 10.1016/j.radcr.2021.02.019. eCollection 2021 May.

Usual interstitial pneumonia progressing to nonspecific interstitial pneumonia-like pattern on high-resolution CT with histologic confirmation

Kai Yazaki  1   2 , Mizu Nonaka  1   2 , Rie Shigemasa  1   2 , Yuko Minami  3 , Takefumi Saito  1 , Nobuyuki Hizawa  2
Affiliations
Case Reports

Usual interstitial pneumonia progressing to nonspecific interstitial pneumonia-like pattern on high-resolution CT with histologic confirmation

Kai Yazaki et al. Radiol Case Rep. .

Erratum in

Abstract

Idiopathic pulmonary fibrosis (IPF) is a progressive and fatal disease. Although high-resolution computed tomography (HRCT) is important for the diagnosis of IPF, the changes in the HRCT findings in IPF are not fully understood. The patient was a 66-year-old man. His HRCT findings had atypically developed from a probable usual interstitial pneumonia pattern to a nonspecific interstitial pneumonia (NSIP) like pattern over 6 years. On the basis of the histologic examination and multidisciplinary discussion, IPF was diagnosed, and nintedanib, administered. This case can be useful for the differential diagnosis of IPF and NSIP.

Keywords: Computed tomography; Idiopathic pulmonary fibrosis; Nonspecific interstitial pneumonia; Usual interstitial pneumonia.

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Figures

Fig. 1
Fig. 1
Chest X-ray image in 2016 showing ground-glass opacities (GGO) and reticular shadows in both the middle and the lower lung fields.
Fig. 2
Fig. 2
(A) HRCT images showing mild subpleural predominant GGO and reticular shadows in both lower lobes in 2010. (B) In 2013, the shadows worsened slightly and peripheral traction bronchiectasis was also present, which were a probable UIP pattern. (C) In 2015, peribronchovascular GGO and reticular shadows appeared. (D) In 2016, the shadows worsened and looked like the f-NSIP pattern, especially in the left lung.
Fig. 3
Fig. 3
Chest HRCT images in 2016 showing peribronchovascular GGO and reticular shadows with traction bronchiectasis predominantly in both lower lobes. There was no honeycombing.
Fig. 4
Fig. 4
Histologic examination of the surgical lung biopsy in the left lung lobe (S6) in 2016. (A, B) Low magnification photomicrograph (magnification: × 4) revealing dense fibrosis with architectural distortion of the predominant subpleural and paraseptal distribution. There was also patchy fibrosis in the lung parenchyma. (C, D) Higher magnification photomicrograph (magnification: × 20) revealing subpleural destructive scarring with fibroblastic foci. (A, C) Hematoxylin and eosin stain. (B, D) Elastica van Gieson stain.
See this image and copyright information in PMC

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