CTICasesRheumatoid Arthritis Associated UIP with NSIP-like CT Pattern
Imaging findings
Chest CT shows a basilar-predominant fibrotic lung disease characterized by subpleural sparing, traction bronchiectasis, and lower zone predominant cystic spaces. While the imaging pattern suggested cellular or fibrotic NSIP, surgical lung biopsy demonstrated a classic UIP pattern.
Key takeaways
In patients with rheumatoid arthritis or other connective tissue diseases, the CT pattern can be discordant with pathology. A pattern mimicking NSIP on CT (with subpleural sparing) can turn out to be UIP on surgical lung biopsy, which carries a worse prognosis and faster progression.
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