IMPORTANT: We currently have a number of bugs related to image cropping and are actively trying to resolve them. In the meantime, we have disabled cropping. Apologies for any inconvenience. Stay informed: radiopaedia.org/chat

Fibrotic hypersensitivity pneumonitis

Case contributed by Melbourne Uni Radiology Masters
Diagnosis certain

Presentation

Increasing shortness of breath for 8 months.

Patient Data

Age: 80-year-old
Gender: Female

CT Chest - HRCT

ct

Inspiratory and expiratory scans of the chest have been performed along the dynamic series of the chest.

Extensive changes of pulmonary fibrosis remain stable and there is mosaic attenuation in both lungs exacerbated in the expiratory film.

These appearances are stable when compared to the previous study.

No focal mass within the lungs. Mediastinal lymph nodes are numerous but within normal size limits and are likely reactive.

Case Discussion

The changes are characteristic of pulmonary fibrosis.

This patient had a long history of exposure to pigeons as a hobby, and the CT findings are in keeping with end-stage chronic hypersensitivity pneumonitis.

On HRCT,  chronic hypersensitivity pneumonitis usually has the following features:

  • established pulmonary fibrosis with honeycomb formation
  • may see ground glass opacification
  • areas of lobular air-trapping

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.