Chest
Volume 93, Issue 1, January 1988, Pages 215-217
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Selected Reports
Desquamative Interstitial Pneumonia: Computed Tomographic Findings before and after Treatment with Corticosteroids

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Noninvasive methods for diagnosis, assessing prognosis, and following response to treatment in idiopathic pulmonary fibrosis (IPF) have yet to prove their usefulness. We report a patient with desquamative interstitial pneumonia (DIP) in whom computed tomography (CT) suggested the diagnosis by the presence of patchy areas of haziness predominantly in a peripheral distribution. The chest x-ray and physical examinations, and the arterial blood gases showed normal findings after one month of treatment with corticosteroids, at which time the CT scan and lung volumes were still abnormal. At three months, lung volumes and the CT scan were normal. Hazy densities in a peripheral distribution on CT may indicate active IPF associated with a good prognosis.

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Case Report

A 36-year-old man was referred because of a four-month history of a dry cough and dyspnea on exertion. No other symptom was present. He had worked at a wood fiber and chip mill for ten years without any respiratory symptoms. He stopped working when his symptoms began but did not improve. There was no history of recent travel and he had no unusual hobbies or exposure to animals. He was an intermittent cigarette smoker and used marijuana and cocaine on occasion, but denied use of any other

Discussion

The appearance of idiopathic pulmonary fibrosis (IPF) on CT has been described as consisting of reticular densities in a patchy distribution predominantly in the subpleural region of the lungs.4 This is to be distinguished from the distribution of hypersensitivity pneumonitis which is central or diffuse and of sarcoidosis which tends to follow the bronchovascular bundles.5 The patchy hazy densities seen in this patient had a similar distribution to that seen in UIP. However, in all patients

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