QUIZ: No. 6, April 6 , 2025

Case 6 (06/04/2025): A 55-year-old female presented with complaints of shortness of breath and cough for 2 months. No significant medical and surgical history. NCCT Chest images are provided. What’s your diagnosis?

Case 6 (06/09/2025)A 55-year-old female presented with complaints of shortness of breath and cough for 2 months. No significant medical and surgical history. NCCT Chest images are provided. What’s your diagnosis?

CASE 6

A 55-year-old female presented with complaints of shortness of breath and cough for 2 months. No significant medical and surgical history. NCCT Chest images are provided. What’s your diagnosis?

ANS – Cryptogenic Organising Pneumonia

Findings: Bilateral lower zone and peripheral predominant ground-glass opacity with a peripheral ring of consolidation – Atoll sign

Cryptogenic organizing pneumonia is a disease of unknown etiology characterized on imaging by multifocal ground-glass opacifications and/or consolidation.

Arcade-like sign refers to perilobular fibrosis as a result of perilobular inflammation and seen as an arcade or arched appearance of consolidation bands distributed around the structures surrounding the secondary pulmonary lobules.

DD: Chronic eosinophilic pneumonia (CEP)

COP tends to show lower lobe predominance, while CEP shows upper lobe involvement. 

Take home points

Presence of multifocal areas of airspace consolidation that are peripheral or peribronchial in distribution, have a predilection for the lung bases favor the diagnosis of OP.

P.S – BAL done in this case confirmed the diagnosis of COP and the patient was treated with corticosteroids.