1. Radiological and pathological findings in a common variable immunodeficiency patient with granulomatous-lymphocytic interstitial lung disease. a) High-resolution computed tomography: axial, coronal and sagittal views show several nodules with peri-lymphatic...
Radiological and pathological findings in a common variable immunodeficiency patient with granulomatous-lymphocytic interstitial lung disease. a) High-resolution computed tomography: axial, coronal and sagittal views show several nodules with peri-lymphatic distribution without predominance in the upper lobes, and the co-existence of bronchiectasis. b) Positron emission tomography/computed tomography findings shows hilar lymph nodes and peri-lymphatic nodules on fluorodeoxyglycose (FDG) uptake, an inhomogeneous FDG uptake area of consolidation at the right lower lobe of the lung, and inhomogeneous liver and spleen FDG uptake with splenomegaly. Bone marrow activation images are also detectable. Bronchoalveolar lavage fluid cell analysis showed lymphocytosis (25%) with an increase in B-cells (73% were represented by CD21 low-activated B-cells). Lymphoproliferative disease was initially ruled out through trans-bronchial biopsy. Surgical lung biopsy examination was consistent with granulomatous-lymphocytic interstitial lung disease. Liver biopsy examination showed nodular lymphoid hyperplasia. c, d) Pathological findings from surgical lung biopsy. c) Bronchiolar and peri-bronchiolar inflammation with follicular bronchiolitis and contiguous parenchymal involvement (haematoxylin and eosin staining, ×25 original magnification). d) Microgranuloma with a giant cell surrounded by foamy and epithelioid macrophages (haematoxylin and eosin staining, ×200 original magnification).
Francesco Cinetto et al. Eur Respir Rev 2018;27:180019
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