CTICasesFibrotic Hypersensitivity Pneumonitis
Imaging findings
CT chest shows progressive reticulation, traction bronchiectasis, and ground-glass opacities in a bronchocentric distribution with upper-to-mid lung predominance, sparing the costophrenic angles. Honeycombing is absent. Histopathology showed chronic bronchiolar inflammation, airway-centered fibrosis, and loose granulomas.
Key takeaways
Fibrotic hypersensitivity pneumonitis (HP) is an important differential for fibrotic lung disease. Unlike UIP, it often demonstrates bronchocentricity, upper lobe predominance, and signs of airway injury (like air trapping or centrilobular nodules), and histopathology reveals bronchiolocentric fibrosis.
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