Acute interstitial pneumonitis

Case contributed by Hani Makky Al Salam
Diagnosis almost certain


Progressive shortness of breath.

Patient Data

Age: 65 years
Gender: Female

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

Bi-basilar and dependent ground glass opacities, interlobular septal thickening and mild traction bronchiectasis.

6 month follow up


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

One year from initial x-ray


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

Another 6 month follow up


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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