CTICasesNSIP with Organizing Pneumonia
Imaging findings
High-resolution chest CT demonstrates highly symmetric, lower-lobe predominant ground-glass opacities and reticulation consistent with non-specific interstitial pneumonia (NSIP). Superimposed on this is a sharp, wavy, continuous band of subpleural consolidation resembling a "reverse halo" or "atoll" sign, jokingly termed the "oak leaf" or "grapefruit segments" pattern, which represents organizing pneumonia.
Key takeaways
Organizing pneumonia (OP) and non-specific interstitial pneumonia (NSIP) frequently co-exist in patients with connective tissue disease (CTD). The organizing pneumonia component typically manifests as subpleural consolidations (often with an "atoll" or wavy band configuration) that show a rapid response to corticosteroid therapy, leaving the underlying, more stable fibrotic NSIP pattern visible on follow-up imaging.
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