Fibrotic hypersensitivity pneumonitis (fHP) is is a chronic, often progressive fibrosing form of hypersensitivity pneumonitis and is also often categorized at a form of interstitial lung disease. Manifestations previously categorized as chronic hypersensitivity pneumonitis now fall under this category. As with other forms of hypersensitivity pneumonitis it is caused by inhaled antigenic exposures.
Radiographic features
CT
The associated lung fibrosis can frequently demonstrate bronchocentricity 5
Some suggest using three descriptors such a typical, compatible with or indeterminate 3
-
fibrotic typical HP pattern
- coarse reticulation and minimal honeycombing in a random axial distribution with no zonal predominance in association with
- small airway disease
-
fibrotic compatible-with-HP pattern varies in the patterns and/or distribution of lung fibrosis
- (e.g., basal and subpleural predominance
- upper-lung-zone predominance
- central or peribronchovascular predominance
- fibrotic ground-glass attenuation seen alone or in association with small airway disease.
-
fibrotic indeterminate-for-HP pattern includes
- usual interstitial pneumonia pattern
- nonspecific interstitial pneumonia pattern
- organizing pneumonia-like pattern
- truly indeterminate findings
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