Wang HJ, Chen XJ, Fan LX, Qi QL, Chen QZ. Rare imaging findings of hypersensitivity pneumonitis: A case report. World J Clin Cases 2020; 8(20): 5057-5061 [PMID: 33195682 DOI: 10.12998/wjcc.v8.i20.5057]
Corresponding Author of This Article
Hong-Juan Wang, PhD, Doctor, Department of Respiratory Medicine, Gansu Provincial People's Hospital, No. 204 Donggang West Road, Lanzhou 730000, Gansu Province, China. coldrain_591@163.com
Research Domain of This Article
Medicine, Research & Experimental
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Hong-Juan Wang, Xiao-Jun Chen, Lin-Xia Fan, Qi-Zhang Chen, Department of Respiratory Medicine, Gansu Provincial People's Hospital, Lanzhou 730000, Gansu Province, China
Qiao-Ling Qi, Department of Respiratory Medicine, The First People's Hospital of Zhenyuan County, Lanzhou 730000, Gansu Province, China
Author contributions: Wang HJ and Qi QL were the patient’s doctors, reviewed the literature, and contributed to manuscript drafting; Chen QZ, Chen XJ, Fan LX, and Wang HJ analyzed and interpreted the imaging findings; Chen QZ and Fan LX were responsible for the revision of the manuscript for important intellectual content; all authors issued final approval for the version to be submitted.
Supported bythe Scientific Research Project of Gansu Provincial People's Hospital, No. 2019-290.
Informed consent statement: Informed consent was obtained for the patient for this case report.
Conflict-of-interest statement: We declare that we have no conflict of interest to disclose.
CARE Checklist (2016) statement: We have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hong-Juan Wang, PhD, Doctor, Department of Respiratory Medicine, Gansu Provincial People's Hospital, No. 204 Donggang West Road, Lanzhou 730000, Gansu Province, China. coldrain_591@163.com
Received: July 16, 2020 Peer-review started: July 16, 2020 First decision: August 21, 2020 Revised: August 22, 2020 Accepted: September 5, 2020 Article in press: September 5, 2020 Published online: October 26, 2020 Processing time: 101 Days and 23.7 Hours
Abstract
BACKGROUND
Hypersensitivity pneumonitis (HP) is an immune-mediated syndrome caused by allergen inhalation. High-resolution computed tomography (HRCT) of HP may show diffuse ground-glass opacity, centrilobular ground-glass nodules, areas of air-trapping, thin-walled cysts, or fibrotic changes.
CASE SUMMARY
A 47-year-old male patient went to the hospital complaining of cough and gradual aggravation of shortness of breath. HRCT of the lung showed that multiple nodules and ground-glass high-density shadows were present in both lungs. In addition, circular high-density shadows of various sizes were widely distributed in both lungs with relatively normal lung markings inside them. But other tests did not have a positive finding that can clarify the cause. Therefore, the patient underwent a lung biopsy. The pathological results showed that the lesions tended to be HP. After 4 mo of follow-up, the lesions in the patient's lungs were absorbed spontaneously, and the symptoms of cough and shortness of breath have disappeared. The review results suggested that the patient’s disease was self-healing, which was consistent with the characteristics of HP.
CONCLUSION
For some patients with HP, abnormal HRCT findings, such as the lesions in the lungs, can be absorbed on their own, which is an important clue in the diagnosis of the disease. Early diagnosis by lung biopsy is necessary when antigen exposure is unknown.
Core Tip: We report a case of hypersensitivity pneumonitis (HP) with special high-resolution computed tomography (HRCT) findings. Circular high-density shadows of various sizes were widely distributed in both lungs with lung markings inside them. For some patients with HP, abnormal HRCT findings, such as the lesions in the lungs, can be absorbed on their own, which is an important clue in the diagnosis of the disease.
