CTICasesRecurrent acute farmers lung (hypersensitivity pneumonitis)
Imaging findings
Initial CT of a farm worker shows diffuse ground-glass opacities and spared lobules (active HP), which completely resolved after steroid therapy and antigen avoidance. Two years later, re-exposure to farm dust led to recurrence of identical ground-glass opacities and air trapping in the exact same lobules.
Key takeaways
Acute HP is characterized by diffuse ground-glass opacities and lobular air trapping (three-density sign). Re-exposure to the offending agricultural antigen can trigger an identical acute flare in the same lobules, likely due to pre-existing bronchiolar scarring/remodeling.
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