CTICasesDesquamative Interstitial Pneumonia (DIP) in a Heavy Smoker
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Imaging findings
Chest radiograph shows a subtle diffuse fine reticular pattern. CT of the lungs reveals features of smoker's lung, including emphysema, with some larger cystic spaces potentially representing Langerhans cell histiocytosis. There is a diffuse background hyperattenuation throughout the lungs, most likely due to the accumulation of smoker's macrophages. Possible upper lung fibrosis is also noted.
Key takeaways
This case, in a heavy smoker, is a presumed diagnosis of Desquamative Interstitial Pneumonia (DIP), characterized by diffuse ground-glass hyperattenuation attributed to abundant smoker's macrophages, often co-existing with emphysema and possibly Langerhans cell histiocytosis. The findings represent a spectrum of smoking-related lung injury, and illustrate how these can combine to produce striking imaging.
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