A 63-Year-Old Woman With an Acute Exacerbation of Interstitial Pneumonia

      Case Presentation

      A 63-year-old, non-smoking Asian woman presented to our hospital due to abnormal findings on chest radiography. She had no history of dust exposure. Chest radiography and CT imaging showed patchy ground-glass attenuation (GGA) in the bilateral lower lung lobes, a ground-glass nodule in the right lower lung lobe (diameter, 9.8 mm), and some thin-walled cysts in both lungs (Fig 1). Thickening of the interlobular septa, mediastinal lymphadenopathy, and pleural effusion were not evident. Video-assisted thoracic surgery was performed for the examination of the nodule and the background lung disease, and the nodule was histologically diagnosed as lung adenocarcinoma. Simultaneously, the lung background showed diffuse lymphocytic infiltration in the alveolar septum and peribronchovascular interstitium (Fig 2). There were no symptoms suggestive of autoimmune diseases such as dryness, arthralgia, skin rash, or fever. The patient was followed up without treatment for the interstitial lung disease.
      To read this article in full you will need to make a payment
      Subscribe to CHEST
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Liebow A.A.
        • Carrington C.B.
        Diffuse pulmonary lymphoreticular infiltrations associated with dysproteinemia.
        Med Clin North Am. 1973; 57: 809-843
        • American Thoracic Society, European Respiratory Society
        American Thoracic Society/European Respiratory Society International Multidisciplinary Consensus Classification of the Idiopathic Interstitial Pneumonias. This joint statement of the American Thoracic Society (ATS), and the European Respiratory Society (ERS) was adopted by the ATS board of directors, June 2001 and by the ERS Executive Committee, June 2001.
        Am J Respir Crit Care Med. 2002; 165: 277-304
        • Travis W.D.
        • Costabel U.
        • Hansell D.M.
        • et al.
        An official American Thoracic Society/European Respiratory Society statement: update of the international multidisciplinary classification of the idiopathic interstitial pneumonias.
        Am J Respir Crit Care Med. 2013; 188: 733-748
        • Panchabhai T.S.
        • Farver C.
        • Highland K.B.
        Lymphocytic interstitial pneumonia.
        Clin Chest Med. 2016; 37: 463-474
        • Koss M.N.
        • Hochholzer L.
        • Langloss J.M.
        • Wehunt W.D.
        • Lazarus A.A.
        Lymphoid interstitial pneumonia: clinicopathological and immunopathological findings in 18 cases.
        Pathology. 1987; 19: 178-185
        • Płóciniczak A.
        • Goździk-Spychalska J.
        • Batura-Gabryel H.
        Interstitial pneumonia with autoimmune features (IPAF) and radiological findings suggestive of lymphocytic interstitial pneumonia (LIP)—case report.
        Adv Respir Med. 2017; 84: 46-50
        • Collard H.R.
        • Ryerson C.J.
        • Corte T.J.
        • et al.
        Acute exacerbation of idiopathic pulmonary fibrosis an international working group report.
        Am J Respir Crit Care Med. 2016; 194: 265-275
        • Johkoh T.
        • Fukuoka J.
        • Tanaka T.
        Rare idiopathic intestinal pneumonias (IIPs) and histologic patterns in new ATS/ERS multidisciplinary classification of the IIPs.
        Eur J Radiol. 2015; 84: 542-546
        • Lee K.C.
        • Kang E.Y.
        • Yong H.S.
        • et al.
        A stepwise diagnostic approach to cystic lung diseases for radiologists.
        Korean J Radiol. 2019; 20: 1368-1380
        • Cantin L.
        • Bankier A.A.
        • Eisenberg R.L.
        Multiple cystlike lung lesions in the adult.
        Am J Roentgenol. 2010; 194: 1-11
        • Tanaka T.
        • Ishida K.
        Update on rare idiopathic interstitial pneumonias and rare histologic patterns.
        Arch Pathol Lab Med. 2018; 142: 1069-1079
        • Ichikawa Y.
        • Kinoshita M.
        • Koga T.
        • Oizumi K.
        • Fujimoto K.
        • Hayabuchi N.
        Lung cyst formation in lymphocytic interstitial pneumonia: CT features.
        J Comput Assist Tomogr. 1994; 18: 745-748
        • Swigris J.J.
        • Berry G.J.
        • Raffin T.A.
        • Kuschner W.G.
        Lymphoid interstitial pneumonia: a narrative review.
        Chest. 2002; 122: 2150-2164