IMAGES IN THORAX
A woman in her mid 30s with a dry cough and breathlessness
1 Respiratory Department, Royal Hampshire County Hospital, Winchester, UK
2 Respiratory Department, Great Western Hospital, Swindon, UK
3 Histopathology Department, Royal Brompton Hospital, London, UK
Correspondence to:
Dr H K Ramadan, Respiratory Department, Royal Hampshire County Hospital, Winchester SO22 5DG, UK; hkhk00@hotmail.com
| The first 150 words of the full text of this article appear below. |
A female non-smoker in her thirties was referred to the chest clinic with a 6-month history of a dry cough, breathlessness and general malaise.
Her chest x ray showed diffuse bilateral ground-glass opacity (fig 1). Her autoimmune profile was negative. An HIV test was negative. Lung function tests showed a restrictive pattern with moderately reduced transfer factor.
Figure 1 Chest x ray: diffuse bilateral ground-glass opacity.
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A high resolution CT (HRCT) showed bilateral ground-glass opacity, more marked on the right, with no evidence of mediastinal or hilar lymphadenopathy (fig 2).
Figure 2 High resolution CT: ground-glass opacity is seen predominantly on the right.
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A bronchoscopy showed a normal tracheobronchial tree. Bronchoalveolar lavage contained large numbers of foamy macrophages and increased neutrophils, and microbiogical tests were negative.
A surgical lung biopsy was undertaken (fig 3). Ultrastructural analysis showed giant lamellar structures within the cytoplasm of the alveolar macrophages, and
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Thorax 2009 64: i.[Extract] [Full Text] [PDF]
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