An unusual cause of breathlessness and profuse micronodules

Lung India : Official Organ of Indian Chest Society
Srinivas RajagopalaRajendiran Gopalan

Abstract

We describe a 21-year-old male with a history of smoking and subacute onset of breathlessness with normal cardiorespiratory examination. The presence of "track marks" and digital infarcts prompted evaluation for infective endocarditis and confrontational history taking revealed anorexia, weight loss over 3 months along with intravenous drug abuse of reconstituted tablets of tapentadol. Echocardiography was normal and blood cultures were sterile; computed tomography showed bilateral, diffuse, small centrilobular nodules with "tree-in-bud" appearance. In this clinicopathologic conference, we discuss the clinical and radiological differential diagnosis of centrilobular nodules, lung biopsy findings, and management options for patients with such a presentation.

References

Oct 24, 2014·AJR. American Journal of Roentgenology·Vicky T NguyenSudhakar N J Pipavath

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Methods Mentioned

BETA
enzyme-linked immunosorbent assay
biopsy
bronchoalveolar lavage

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