Case 90: The Probable UIP Conundrum - Time Matters

Table of Contents

Index and Table of Contents
Technical and Practice Issues * Case 11: 62-years old misdiagnosed to have interstitial lung disease - mid-inspiratory and expiratory scans * Snippet 03: Radiation risk and CT chest * Case 23: 60-years old - 40-pack years smoker - right upper lobe nodule - resolved using “mean” reconstructions…

Case

A 57-years old, non-smoker, presented with gradually progressive dyspnea in 2017.

The patient presented with a probable UIP pattern, which I have discussed earlier.

Case 6: Probable Usual Interstitial Pneumonia (Probable UIP) - IPF
63-years old man with probable UIP IPF. The video discusses the case, the differentiation from typical UIP IPF and the importance of traction bronchiectasis.
Axial and sagittal images showing reticular opacities, traction bronchiectasis and subpleural basal predominance without honeycombing

He had no connective tissue disease and no other history. What would you do next?

  1. Treat as UIP/IPF
  2. Biopsy
  3. Treat as fibrotic NSIP / occult connective tissue disease

To help you, here is the snippet I had done two years ago that helps us make sense of the probable UIP/fibrotic NSIP issue.

Snippet 04: Fibrotic NSIP vs Probable UIP
A flow-chart to help differentiate between NSIP and probable UIP - a commonly asked question
The video below discusses this case, why this is probable UIP, what happened and why follow-up matters. Follow-up scans of 2020 and 2022 are shown and discussed. Please click on the Subscribe button below to see the video.