CTICasesAcute Hypersensitivity Pneumonitis (Gray Lungs/Black Bronchus Sign)
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Imaging findings
A patient with restrictive lung disease and DLCO abnormalities had a chest radiograph and CT showing diffuse bilateral 'gray lungs,' characterized by extensive and confluent central lobular nodules. Some air trapping was also noted.
Key takeaways
This is a classic presentation of hypersensitivity pneumonitis, demonstrating the 'gray lungs' appearance and the 'black bronchus sign,' where the blackness of air in the bronchi stands out against the diffuse ground-glass opacification of the lungs. Follow-up imaging showed significant improvement after treatment. Hypersensitivity pneumonitis is a form of ILD.
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