Description

A 24-year-old woman presented with an 8-year history of chest tightness and shortness of breath during intense exercise. Physical examination showed decreased expansion of the right rib cage and respiratory sounds in the right lung were quiet. A routine examination was unremarkable. There were no systemic symptoms, including fever, skin rash and arthralgia. The erythrocyte sedimentation rate and high sensitivity C-reactive protein levels were normal. Autoantibodies, including antinuclear antibodies, antiextractable nuclear antigen antibodies and antineutrophil cytoplasmic antibodies, were negative.

Chest high-resolution CT showed a low right lung volume, markedly thickened interlobular septae (mainly in the right lower lung) and some ground-glass opacity, showing a wedge-shaped area of consolidation (figure 1A). Bronchoscopy showed submucosal varices of the right bronchial tree, with markedly increased surface secretions and mucosal hypertrophy (figure 2). Echocardiography showed normal inner atrial and ventricular diameters. Additionally, ostia of the right superior pulmonary vein were unclear, and pulmonary arterial systolic pressure was normal. CT pulmonary angiography …