CTICasesFish Antigen Hypersensitivity Pneumonitis
Imaging findings
Chest radiographs show diffuse, small centrilobular nodular opacities primarily concentrated in the mid-to-upper lung zones. CT confirms a heavy burden of well-defined centrilobular nodules with relative sparing of the immediate subpleural spaces, indicating a classic airway-centered distribution. Coronal reformats nicely highlight the upper lung predominance of the disease.
Key takeaways
Hypersensitivity pneumonitis can be triggered by organic antigens encountered in the seafood industry, specifically fish antigens. While typical acute or subacute hypersensitivity pneumonitis presents with poorly defined ground-glass nodules, chronic or long-standing cases can show firmer, crisper, and more well-defined nodules representing mucus plugging or chronic bronchiolar inflammation.
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