CTICasesAirway-Centric Hypersensitivity Pneumonitis
Imaging findings
CT chest shows diffuse, centrilobular ground-glass nodules and lobular air trapping on expiratory CT. Transbronchial biopsy demonstrated well-formed, non-caseating granulomas centered on the airways and bronchioles, along with chronic bronchiolitis.
Key takeaways
Hypersensitivity pneumonitis (HP) is an immune-mediated inflammatory lung disease triggered by inhaled antigens. The classic CT features are poorly-defined centrilobular ground-glass nodules and mosaic attenuation/air trapping. Pathologically, HP is characterized by an airway-centric lymphocytic infiltrate and loosely-formed granulomas, but some cases (such as hot-tub lung or specific mold exposures) can show highly well-formed airway-centric granulomas mimicking sarcoidosis.
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