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A 53-yr-old man with dyspnea (ATS Gr.IV) onset 2 개월 전 , recent agg. 10 일 전

A 53-yr-old man with dyspnea (ATS Gr.IV) onset 2 개월 전 , recent agg. 10 일 전. Ex-smoker (1.5pack x 20yr, 13 년 전 부터 금연 ) 사무직 2 개월 전 dry cough develop 1 개월 전 dyspnea develop, 빨리 걸으면 숨참 10 일 전 dyspnea agg. resting 시에도 sx.(+), local visit, CXR 이상 있다 하여 7 일 전 지역 종합병원 입원

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A 53-yr-old man with dyspnea (ATS Gr.IV) onset 2 개월 전 , recent agg. 10 일 전

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  1. A 53-yr-old man with dyspnea (ATS Gr.IV)onset 2개월 전, recent agg. 10일 전 • Ex-smoker (1.5pack x 20yr, 13년 전 부터 금연) • 사무직 • 2개월 전 dry cough develop • 1개월 전 dyspnea develop, 빨리 걸으면 숨참 • 10일 전 dyspnea agg. resting시에도 sx.(+), local visit, CXR 이상 있다 하여 7일 전 지역 종합병원 입원 • 07.10.29 IM3 opd 예약 상태로 주말 사이 dyspnea agg.되어 SMC ER visit • *PFT: FVC 1.48L(38%), FEV1 1.38L(44%) FEV1/FVC 93.3%, TLC 2.81L(45.5%) DLCO 19.4%severe restrictive patternnegative bronchodilator response • ABGA: 7.485-32.4-48.3-23.9-87.4%

  2. Diffuse ground-glass opacity on the both lung, and reticular opacity on lower lung zone Chest PA and left lateral 20575121

  3. Chest CT Diffuse ground-glass opacity on the both lung, area of decreased attenuation suggesting air trapping and centrilobular nodules

  4. Histology, scanning power Cellular chronic interstitial pneumonia, accentuated in peribronchiolar parenchyma

  5. Pathology findings I Combination of a cellular chronic interstitial pneumonia, accentuated in peribronchiolar parenchyma, ill-defined non-necrotizing granulomas

  6. Pathology findings II Combination of a cellular chronic interstitial pneumonia, accentuated in peribronchiolar parenchyma, ill-defined non-necrotizing granulomas (arrows)

  7. HYPERSENSITIVITY PNEUMONIA( EXTRINSIC ALLERGIC ALVEOLITIS ) Pathology findings III ill-defined non-necrotizing granulomas (arrows)

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