Case 245

 An eighty five-year-old male presented in our hospital for shortness of breath. He had been suffering from interstitial pulmonary fibrosis, given pulse spray steroid therapy for the past four months. Steroid volume was given from 30mg/day for a month, 25mg/day for two weeks, 20mg/day for a month, 15mg/day for a month. After the schedule, he was given the decreased steroid 12.5mg/day. Three days after the decrease, his respiratory symptoms worsened: PO2 70mmHg. Laboratory test revealed white blood cells 9630/mm3 , neutrophils 87.5%, lymphocyte 6.5% (629/mm3), CRP 8.64 mg/dL, BNP 127pg/mL, KL 6 1730 U/mL, D glucan 7.0pg/mL, cryptococcus negative. He took chest CT for further investigation.

What imaging findings are shown on chest CT ?

1.　Honeycomb appearance

2.　Bronchiectasis traction

3.　Consolidation

4.　Various stage of interstitial change

5.　All

answer

2021.10.1