CTICasesChronic Fibrotic Hypersensitivity Pneumonitis
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Imaging findings
Chest CT reveals a fibrotic lung disease pattern characterized by perihilar and upper-lobe-predominant fibrosis. In addition, there is prominent mosaic attenuation with areas of air trapping in the lower lobes, alongside faint centrilobular micronodules superimposed on the fibrotic changes.
Key takeaways
Chronic fibrotic hypersensitivity pneumonitis (HP) typically exhibits a perihilar and upper-to-mid-lung predominant distribution of fibrosis, distinguishing it from idiopathic pulmonary fibrosis (IPF). The presence of mosaic attenuation, air trapping on expiratory imaging, and superimposed acute centrilobular nodules suggests persistent or ongoing exposure to the inciting antigen (such as avian proteins in a bird keeper).
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