Rheumatoid interstitial lung disease (moderate)

Case contributed by Bálint Botz
Diagnosis almost certain

Presentation

Known rheumatoid arthritis on treatment for approximately 15 years. A recent CXR demonstrated bilateral increased interstitial markings in the basal lung regions. Noncontrast chest CT requested to evaluate possible RA-associated interstitial lung disease.

Patient Data

Age: 45 years
Gender: Female
This study is a stack
Axial lung
window
Sagittal
left side
Sagittal
right side
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Info

CT demonstrates a primarily peripheral, subpleural pulmonary fibrosis, which particularly affects the basal segments of the lower lobes (see representative sagittal plane images). Associated honeycombing and bronchiectasis can also be observed. 

Annotated image
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Info

Magnified key image demonstrating bronchiectasis, subpleural reticulation and honeycombing. 

Case Discussion

Altogether the findings show a distinct UIP pattern, and considering the history are in line with RA-associated ILD.

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