Case Report
Volume: 5 | Issue: 2 | Published: Feb 19, 2021 | Pages: 39 - 42 | DOI: 10.24911/ejmcr/173-1587546527
A CT emphysema pattern in a non-smoker classical guitar teacher
Authors: Claudia Roncella , Paolo Busatto , Greta Ali , Giulio Rossi , Annalisa De Liperi , Sara Fiorini , Laura Tavanti , Chiara Romei
Article Info
Authors
Claudia Roncella
Pisa University Hospital, Dipartimento Diagnostica per Immagini, UO Radiodiagnostica 1, Pisa, Italy
Paolo Busatto
San Luca of Lucca Hospital, Pneumologia Lucca, Italy
Greta Ali
Pisa University Hospital, Dipartimento di Patologia Chirurgica, Medica, Molecolare e dellArea Critica, Anatomia Patologica III, Pisa, Italy
Giulio Rossi
Hospital District Ravenna, Dipartimento Anatomia Patologica, Medicina Trasfusionale e di Laboratorio, Unità di Anatomia Patologica, Ravenna, Italy
Annalisa De Liperi
Pisa University Hospital, Dipartimento Diagnostica per Immagini, UO Radiodiagnostica 2, Pisa, Italy
Sara Fiorini
Pisa University Hospital, Dipartimento Diagnostica per Immagini, UO Radiodiagnostica 1, Pisa, Italy
Laura Tavanti
Pisa University Hospital, Dipartimento Cardio-toracovascolare, UO Pneumologia Universitaria, Pisa, Italy
Chiara Romei
Pisa University Hospital, Dipartimento Diagnostica per Immagini, UO Radiodiagnostica 2, Pisa, Italy
Publication History
Received: May 05, 2020
Revised: September 29, 2020
Accepted: October 21, 2020
Published: February 19, 2021
Abstract
Background: Hypersensitivity pneumonitis (HP) is a complex syndrome due to an inflammatory response of the lungs to many aerosolized antigens. HP can be divided into acute, subacute, and chronic phenotypes, which frequently overlap. Case presentation: We describe the case of a non-smoker man admitted to the hospital for flu-like symptoms who presented emphysema as an evolution of HP. The diagnosis of HP was proposed by a multidisciplinary team based on the clinical/functional data and CT findings; two chest CTs were compared: a CT was performed during the hospitalization of the patient and a CT had been performed 5 years before. The diagnosis was confirmed through a lung biopsy. Examining the patient history, a domestic exposition to pigeons and poultry was revealed. Conclusion: HP can lead to emphysema instead of fibrosis. This atypical evolution of HP should be known by clinicians and radiologists in order to suspect it and promptly start the correct diagnostic workup.
Keywords: Hypersensitivity pneumonitis, pulmonary emphysema, multidisciplinary group of interstitial lung disease consult, high-resolution computed tomography, surgical lung biopsy, green
