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Usual interstitial pneumonia

Case contributed by Hidayatullah Hamidi
Diagnosis certain

Presentation

Shortness of breath. Radiologic work up advised to rule out lung neoplasm.

Patient Data

Age: 70 years
Gender: Male

Chest

x-ray

Decreased lung volumes are noted with coarse reticulation appears more pronounced peripherally and caudally.

Chest

ct
  • marked honeycombing bilaterally with traction bronchiectasis and lung volume loss 
  • reticular abnormalities bilaterally
  • subpleural distribution with basal predominance

No feature very inconsistent with UIP pattern such as:

  • ground-glass opacity outside areas of fibrosis
  • mosaic perfusion/air trapping
  • centrilobular nodules
  • perilymphatic nodules
  • subpleural sparing
  • peribronchovascular predominance

Case Discussion

The features are representing a typical case of UIP pattern (definite) according to Diagnostic HRCT criteria for usual interstitial pneumonia (UIP) pattern - ATS/ERS/JRS/ALAT (2018).

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