Acute interstitial pneumonitis

Case contributed by Hani Makky Al Salam

Presentation

Progressive shortness of breath.

Patient Data

Age: 65 years
Gender: Female
x_ray

Low lung volumes with bi-basilar dependent atelectasis/consolidation.
Elevated right hemidiaphragm.

6 month follow up

ct

There is progression of the bi-basilar traction bronchiectasis and parenchymal architectural distortion of the lung bases.

One year from initial x-ray

x_ray

Persistent low lung volume with bi-basilar atelectasis/scarring.

Another 6 month follow up

ct

Persistent, essentially stable, bi-basilar traction bronchiectasis and architectural distortion. 

Case Discussion

This case demonstrates the typical findings of acute interstitial pneumonitis (AIP), considered a rapidly progressive interstitial disease of unknown etiology.

The disease suspicion was confirmed by open lung biopsy which demonstrated the combination of diffuse alveolar damage (DAD) along with some changes of cryptogenic organizing pneumonia (COP).

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