Combined pulmonary fibrosis and emphysema

Case contributed by Dr Amr Farouk

Presentation

70 year old patient with long history of dyspnea, cough and expectoration. Patient is a heavy smoker for 40 years.

Patient Data

Age: 70 year old
Gender: Male

Bilateral panlobular and paraseptal emphysematous changes with subpleural blebs
and bullae formation are noted. Bilateral coarsening of the pulmonary interstitium showing thickening of the interlobular septae with honeycombing and fibrosis involving the left upper lobe, basal lingula, basal middle lobe and both lower lobes' basal segments. These changes show asymmetrical distribution being more pronounced on the left side and basally.

Associated left upper lobe partial collapse is also noted. Multiple pathologically enlarged bilateral hilar and mediastinal lymph nodes are seen at pre-vascular, retrocaval, aorto-pulmonary window and subcarinal locations. Right upper lobe posterior segment calcified pulmonary nodule and retrocaval calcified lymph node are seen indicative of an old granulomatous infection.

Case Discussion

Coexistence of usual interstitial pneumonia (UIP) with emphysema in a chronic smoker suggestive of combined pulmonary fibrosis and emphysema.

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Case information

rID: 57379
Published: 21st Dec 2017
Last edited: 14th Aug 2019
System: Chest
Inclusion in quiz mode: Included

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