CTICasesNSIP and Organizing Pneumonia in Systemic Sclerosis
Imaging findings
A third patient with systemic sclerosis showed a strikingly similar peripheral atoll/reverse-halo pattern of consolidation and ground-glass opacity, but with a more lower-lobe-predominant, uniform distribution and areas of traction bronchiectasis. Surgical lung biopsy confirmed a combination of NSIP and organizing pneumonia.
Key takeaways
The same reverse-halo, organizing-pneumonia pattern of lung injury and healing can occur from different underlying causes, such as idiopathic chronic eosinophilic pneumonia versus connective-tissue-disease-associated NSIP with superimposed organizing pneumonia in scleroderma. The imaging pattern reflects a shared mechanism of lung injury and repair rather than a single specific etiology, and distribution and associated findings such as traction bronchiectasis, lower-lobe predominance, and connective tissue disease history help point toward the underlying cause.
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