CTICasesAsymmetric Idiopathic Pulmonary Fibrosis (IPF)
Imaging findings
A patient demonstrated a dramatic and asymmetric progression of lung fibrosis over a two-year period. Initial imaging showed findings of an interstitial lung disorder with parenchymal reticulation and small foci of subpleural traction bronchiectasis, predominantly affecting the left lung. Over time, there was substantial progression of fibrosis, volume loss, and ultimately massive honeycombing and traction bronchiectasis throughout the left lung, with considerably less severe involvement of the right lung.
Key takeaways
While idiopathic pulmonary fibrosis (IPF) is often characterized by bilateral and symmetric findings, severe asymmetric fibrosis can occur and can progress rapidly. The causes of such asymmetry are debated, with aspiration being a postulated but not definitively proven inciting event.
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