Presentation
Dyspnea.
Patient Data
Gender: Female
From the case:
Usual interstitial pneumonia (probable)
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There is bibasilar subpleural honeycombing with evidence of traction bronchiectasis.
Case Discussion
CT features suggesting the diagnosis of UIP:
- lower lobe predominance, though upper lobe are also involved
- peripheral predominance
- honeycombing
ATS criteria for diagnosis of UIP in absence of surgical lung biopsy.
Major criteria:
- exclusion of other cause of ILD such as drug toxicity, environmental exposure and connective tissue disease
- abnormal PFT with evidence of restrictive pattern
- bibasilar reticular abnormality with minimal ground-glass opacities
- transbronchial BAL showing no feature to support an alternative diagnosis
Minor criteria
- age >50 years
- insidious onset of otherwise unexplained dyspnea on exertion
- duration of illness 3 months
- bibasilar, inspiratory velcro type crackles
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