Usual interstitial pneumonia (probable)

Case contributed by Dr Shankar Poudel

Presentation

Dyspnoea.

Patient Data

Gender: Female
Modality: CT

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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Case Information

rID: 43171
Case created: 26th Feb 2016
Last edited: 28th Feb 2016
System: Chest
Inclusion in quiz mode: Included

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