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Pulmonary function: increased residual volume, increased total lung capacity, fixed obstruction, low diffusing capacity of the lung for carbon monoxide that corrects with alveolar volume; High-resolution CT scan: diffuse pulmonary nodules 4–10 mm, greater than 20 nodules, mosaic attenuation or air trapping in greater than 50% of the lung
Sarcoidosis is an additional cause of a mosaic GGOs due to the formation of granulomas in interstitial areas. This may coexist with granulomatosis with polyangiitis, leading to diffuse areas of increased attenuation with ground-glass appearance.
Where present it is a strong diagnostic factor of ABPA and distinguishes symptoms from other causes of bronchiectasis. [11] CT scans may more rarely reveal mosaic-appearance attenuation, centrilobular lung nodules, tree-in-bud opacities, and pleuropulmonary fibrosis (a finding consistent with CPA, a disease with ABPA as a known precursor). [1]
Since laboratory testing, imaging, and bronchoalveolar lavage results are often non-specific, guidelines recommend surgical biopsy to diagnose desquamative interstitial pneumonia if high-resolution computed tomography does not reveal classic signs of interstitial pneumonia. [17] A definitive diagnosis of DIP relies on a lung biopsy. [18]
Fibrothorax may also occur without a clear underlying cause, in which case it is known as idiopathic fibrothorax. A technique called pleurodesis can be used to intentionally create scar tissue within the pleural space, usually as a treatment for repeated episodes of a punctured lung, known as a pneumothorax, or for pleural effusions caused by ...
Bronchiolitis obliterans results in worsening shortness of breath, wheezing, and a dry cough.The symptoms can start gradually, or severe symptoms can occur suddenly. [9] [10] These symptoms represent an obstructive pattern that is non-reversible with bronchodilator therapy, and need to be related to various lung insults. [11]
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According to the International Labour Office (ILO), PMF requires the presence of large opacity exceeding 1 cm (by x-ray). By pathology standards, the lesion in histologic section must exceed 2 cm to meet the definition of PMF. [6] In PMF, lesions most commonly occupy the upper lung zone, and are usually bilateral.