Hypersensitivity pneumonitis is a diffuse interstitial and granulomatous lung
disease caused by the inhalation of any one of a number of antigens. The
objective of this study was to illustrate the spectrum of abnormalities in
high-resolution computed tomography and histopathological findings related to
hypersensitivity pneumonitis. We retrospectively evaluated patients who had been
diagnosed with hypersensitivity pneumonitis (on the basis of
clinical-radiological or clinical-radiological-pathological correlations) and
had undergone lung biopsy. Hypersensitivity pneumonitis is clinically divided
into acute, subacute, and chronic forms; high-resolution computed tomography
findings correlate with the time of exposure; and the two occasionally overlap.
In the subacute form, centrilobular micronodules, ground-glass opacities, and
air trapping are characteristic high-resolution computed tomography findings,
whereas histopathology shows lymphocytic inflammatory infiltrates,
bronchiolitis, variable degrees of organizing pneumonia, and giant cells. In the
chronic form, high-resolution computed tomography shows traction bronchiectasis,
honeycombing, and lung fibrosis, the last also being seen in the biopsy sample.
A definitive diagnosis of hypersensitivity pneumonitis can be made only through
a multidisciplinary approach, by correlating clinical findings, exposure
history, high-resolution computed tomography findings, and lung biopsy findings.
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