Lymphocytic interstitial pneumonitis

Case contributed by Dr Hani Salam

Presentation

Known case of connective tissue disease. Complaining of gradual onset of progressive dyspnea.

Patient Data

Age: 25
Gender: Female
X-ray

2012

Low lung volume.

CT

2012

Bilateral ground glass nodules and small cysts. Mild interstitial lung changes. 

X-ray

2013

Low lung volume.

X-ray

2014

Low lung volume. 

X-ray

2015

Low lung volume.

CT

2015

Axillary and medistinal lymphadenopathy. Scattered bilateral small thin wall cysts and ground glass nodules. Some of the nodules demonstrates cystic degeneration at the interval. Mild interstitial lung changes. 

Case Discussion

The patient known case of MCTD, SLE, Sjogren syndrome.

This case demonstrates interval degeneration of multiple pre-existing ground glass nodules into emphysematous cysts with millimeter thick walls.  Interval growth of the pre-existing bilateral pulmonary cysts.  Interval development of new bilateral scattered ground glass nodules and interval development of non-specific irregular solid subpleural nodule in the left lower lobe.  Grossly unchanged bilateral axillary and mediatinal lymphadenopathy.  Among the differential diagnostic considerations one should consider Wegener's granulomatosis and lymphocytic interstitial pneumonitis.  If the patient is immunocompromised, PCP and fungal pneumonia should be considered.  Finally, lymphoproliferative disorders and cystic metastases to the lung parenchyma should be excluded.

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Case information

rID: 45611
Published: 20th Mar 2018
Last edited: 20th Mar 2018
System: Chest
Inclusion in quiz mode: Included

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