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Kim, Choi, Park, Cho, Nam, and Mo: Recurrent Desquamative Interstitial Pneumonia with Fibrotic Lung Disease
Case Report
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2008; 65(4): 328-333.

Published online: 31 October 2008

DOI: https://doi.org/10.4046/trd.2008.65.4.328

Recurrent Desquamative Interstitial Pneumonia with Fibrotic Lung Disease

Won Jin Kim, M.D.1, Jeong Hee Choi, M.D.1, Yong Bum Park, M.D.1, Sung Woo Cho, M.D.2, Eun Sook Nam, M.D.3, Eun Kyung Mo, M.D.1

1Department of Internal Medicine, College of Medicine, Hallym University, Seoul, Korea.

2Department of Thoracic Surgery, College of Medicine, Hallym University, Seoul, Korea.

3Department of Pathology, College of Medicine, Hallym University, Seoul, Korea.

Address for correspondence: Eun Kyung Mo, M.D. Department of Internal Medicine, Kangdong Sacred Heart Hospital, 445, Gil-dong, Gangdong-gu, Seoul 134-701, Korea. Phone: 82-2-2225-2524, Fax: 82-2-478-6925, ekmo@hallym.or.kr

Received 2 July 2008       Accepted 11 August 2008

Copyright © 2008 The Korean Academy of Tuberculosis and Respiratory Diseases

Abstract

Desquamative interstitial pneumonia is an uncommon form of interstitial lung diseases and it has a good prognosis compared with other types of idiopathic interstitial pneumonia. A 69-year old man was admitted to our hospital because of a 3-month history of dyspnea. The patient presented with hypoxemia. High-resolution computerized tomography of the patient showed ground glass opacity and traction bronchiectasis with subpleural early honeycombing on the both lung fields. The pathologic findings of the video-assisted thoracoscopy lung biopsy were compatible with desquamative interstitial pneumonia, and irregularly distributed interstitial fibrosis and inflammation were observed at the peripheral parenchyme. Oral predinsolone was started; his symptoms and chest x-ray were improved, and so he stopped taking the prednisolone. Ten months later, the desquamative interstitial pneumonia recurred. We report here on a case of recurrent desquamative interstitial pneumonia with fibrotic lung disease.

Keywords: Desquamative interstitial pneumonia, Recurrent, Fibrotic lung disease

Figures and Tables

Figure 1
(A) At initial presentation, chest x-ray shows ground glass opacity on both lung field. (B) After prednisolone treatment, ground glass opacity is improved.
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Figure 2
HRCT scan shows ground glass opacity, reticular opacities with traction bronchiectasis (arrow) and multiple cystic change with early honeycombing (arrowhead).
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Figure 3
Thoracoscopic lung biopsy of right middle and lower lobes. (A) Alveolar space is filled with amorphous materials (H&H stain, ×10). (B) Interstitium has fibrotic change and alveolar space is filled with alveolar macropahge. Cytoplasm of alveolar space has deep eosinophil, basophilic color. It may be fragment of squamous cell (H&H stain, ×200). (C) At the peripheral parenchyme, irregularly distributed interstitial fibrosis and inflammation are noted with adjacent area of alveolar space filled with alveolar macrophages (H&H stain, ×100).
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Figure 4
(A) In 10 month after, stopping prednisolone, chest X-ray shows ground glass opacity on both lower lobes. (B) HRCT shows diffuse ground glass opacity in both lung fields. Reticular opacities with traction bronchiectasis was improved compared with previous CT scan. (C) Early honeycombing is still remained in both lower lobes.
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Figure 5
After 5 month follow up, ground glass opacity was improved.
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