Question 1:

total lung capacity ins zoom before hrct Zoom

Inspiratory (TLC)

total lung capacity residual volume zoom before hrct Zoom

Expiratory (RV)

total lung capacity ins zoom after hrct Zoom

Inspiratory (TLC)

total lung capacity residual volume zoom after hrct Zoom

Expiratory (RV)

RV, residual volume; TLC, total lung capacity.
Images courtesy of and used with permission from Jonathan Goldin, MD, PhD.

Which of the following features are present in the above axial and coronal HRCT scans?

Correct!

All of these features are present in the above CT scans. Note the importance of obtaining expiratory scans to evaluate the presence of air trapping.

Incorrect!

All of these features are present in the above CT scans. Note the importance of obtaining expiratory scans to evaluate the presence of air trapping.

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Question 2:

total lung capacity inv zoom before hrct 2 Zoom

Inspiratory (TLC)

total lung capacity residual volume zoom before hrct 2 Zoom

Expiratory (RV)

total lung capacity inv zoom after hrct 2 Zoom

Inspiratory (TLC)

total lung capacity residual volume zoom after hrct 2 Zoom

Expiratory (RV)

Images courtesy of and used with permission from Jonathan Goldin, MD, PhD.

What is the most likely diagnosis for this patient?

Correct!

While this HRCT has several features which are consistent with UIP, air trapping excludes a definite diagnosis of UIP. The predominant abnormalities and their distribution are consistent with a diagnosis of chronic hypersensitivity pneumonitis.

Incorrect!

While this HRCT has several features which are consistent with UIP, air trapping excludes a definite diagnosis of UIP. The predominant abnormalities and their distribution are consistent with a diagnosis of chronic hypersensitivity pneumonitis.

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Question 3:

total lung capacity inv zoom before hrct 3 Zoom
total lung capacity residual volume zoom before hrct 3 Zoom

Reprinted with permission from Mueller-Mang C et al. RadioGraphics. 2007;27(3):595-615.

Correctly identify the above images.

Correct!

The image to the left is characterized by subpleural honeycombing, reticulation, and traction bronchiectasis typical of UIP. The image to the right demonstrates ground glass opacity, subpleural linear opacities, and micronodules, typical of NSIP.

Incorrect!

The image to the left is characterized by subpleural honeycombing, reticulation, and traction bronchiectasis typical of UIP. The image to the right demonstrates ground glass opacity, subpleural linear opacities, and micronodules, typical of NSIP.

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Chronic HP Mimicking NSIP
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