Usual interstitial pneumonia - idiopathic pulmonary fibrosis

Presentation

Dyspnoea and reduced exercise tolerance

Patient Data

Age: 80
Gender: Female

The lung volumes are small bilaterally.  There is widespread reticulonodular shadowing throughout both lung fields.  The left hemidiaphragm has been lost, with increased opacification of the left base.

The findings are in keeping with  advanced pulmonary fibrosis.  Underlying infective change, particularly the left base is not excluded.

Moderate bilateral volume loss is demonstrated.  There is advanced pulmonary fibrosis with extensive subpleural interlobular septal thickening and marked peripheral honey combing most pronounced in the bases. Relatively diffuse geographic ground glass opacification is also noted and most consistent with contrast lobular septal thickening/interstitial involvement. Widespread traction bronchiectasis is demonstrated throughout all lobes, most notably within the middle lobe and lingular segments.

Multiple minimally enlarged mediastinal lymph nodes are noted, the largest being an 11 mm inferior pre tracheal node. There is borderline enlargement of the central pulmonary arteries consistent with a degree of pulmonary arterial hypertension. No pleural fluid or pleural nodularity is demonstrated. The oesophagus is normal in calibre.

Conclusion: Advanced pulmonary fibrosis with widespread honey combing, inter and intralobular septal thickening and traction bronchiectasis.

Case Discussion

Typical appearances of end stage idiopathic pulmonary fibrosis.

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Case information

rID: 21995
Case created: 3rd Mar 2013
Last edited: 6th Dec 2016
System: Chest
Inclusion in quiz mode: Included

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