Usual interstitial pneumonia with concomitant intracavitary and endobronchial mycetomas

Case contributed by Avni K P Skandhan
Diagnosis almost certain


History of interstitial lung disease and rheumatoid arthritis. Currently presenting with low-grade fever.

Patient Data

Age: 60 years
Gender: Female

Bilateral inter- and intralobular septal thickening, subpleural honeycombing with a cephalad gradient, and traction bronchiectasis. Intracavitary and intrabronchiectatic soft tissue balls with air crescent rim and displacement of these balls on prone positioning. 

Case Discussion

60-year-old female with known rheumatoid arthritis. She presented with low-grade fever, for which she underwent a CT thorax. The imaging features are compatible with usual interstitial pneumonia (UIP) pattern with associated intracavitary and intrabronchiectatic mycetomas, most probably aspergillomas.

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