Presentation
Known pulmonary fibrosis for 3 years. Recent deterioration with raised inflammatory markers. Probable pneumonia.
Patient Data
There are changes of diffuse and extensive fibrosis in both lungs. Segmental area of consolidation is present in the left upper lobe. An ill defined possible mass lesion is seen at the right base
CT confirms the findings of diffuse and extensive pulmonary fibrosis/UIP pattern
There is an area of consolidation in the left upper lobe, this is most likely due to infection
A mass lesion is seen in the right lower lobe, this is suspicious for a primary lung cancer. This mass was not present on previous CT studies. Some enlarged mediastinal nodes are present.
Case Discussion
The CT findings are characteristic of IPF/UIP pattern.
Lung carcinoma occurs in 5%-15% of patients with IPF, the majority of cancers occur in the lower lobes, peripherally situated and maybe easily be overlooked when they occur in an area of honeycomb formation.
Previous imaging, if and when available, is most useful.
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