Case 268

 An eighty three-year-old female presented in our hospital for fever and dyspnea. Four days before, she felt hard to breeze and three days before, she felt appetite loss and general fatigue after going out. Yesterday, she was diagnosed pneumonia by a local clinic and given a home oxygen therapy. Her respiratory condition worsened. She was on the way of taking steroid and minomycin for contact dermatitis and lymphedema administered by dermatologists.
 Laboratory test revealed CRP 19.59 mg/dL, white blood cells 11850/mm3, neutrophils 84.5%, lymphocytes 9.8%. KL-6 882 U/mL, SP-D 271 ng/mL, SA-A 123.4 ng/ mL. She received CT for further investigation (Figs 1-3).

What is your imaging diagnosis ?

1.　Pulmonary tuberculosis

2.　Non tuberculosis mycobacterial disease

3.　Bacterial pneumonia

4.　Virus pneumonia

5.　Pleuro-parenchymal fibroelastosis

answer

2022.6.13