77 yo M with 3 weeks of cough and SOB

Original case provided by Lauren Brown, MD.
Edits, teaching points and graphics by Yilin Zhang, MD.


OBJECTIVES:



CASE:

A 77 yo M presents with 3 weeks of nonproductive cough and exertional dyspnea. He denies any chest pain, orthopnea or lower extremity edema. He denies URI symptoms, fevers/chills or recent sick contacts. At baseline, he is able to walk several miles without difficulty and now is limited to < 1 city block. His PMH is notable for paroxysmal atrial fibrillation for which he has been on warfarin and amiodarone for several years. He also has an AICD for his history of non-ischemic cardiomyopathy (most recent EF of 40%).

CXR

What is your differential for these CXR findings?


CT Chest

OUTCOME AND FINAL DIAGNOSIS:

TAKE HOME POINTS:


 

REFERENCES:

  1. Kadoch, MA, et al. Idiopathic Interstitial Pneumonias: A Radiology-Pathology Correlation Based on the Revised 2013 American Thoracic Society-European Respiratory Society Classification System. Current Problems in Diagnostic Radiology. 2015; 44(1): 15-25.
  2. Wolkove, N & Baltzan, M. Amiodarone pulmonary toxicity. Canadian Respiratory Journal. 2009; 16(2): 43-48.