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Evolution of Desquamative Interstitial Pneumonia

Imaging findings

Serial CT chest scans over a 10-year period show progressive transition from diffuse, bilateral ground-glass opacities in a heavy smoker (consistent with active DIP) to lower-zone-predominant fibrotic changes, traction bronchiectasis, and honeycombing.

Key takeaways

Desquamative Interstitial Pneumonia (DIP) is a smoking-related interstitial lung disease characterized by alveolar accumulation of pigmented macrophages. Although often steroid-responsive and reversible with smoking cessation, long-standing untreated DIP can slowly progress to irreversible pulmonary fibrosis.

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