BIP Pattern with PPF - 9 Years Follow Up of Hypersensitivity Pneumonitis

What happens over 9 years

Bhavin Jankharia

Case

53-year-old with a fibrotic ILD with extensive cystic change in the upper lobes and a BIP appearance in the lower lobes. Just this one scan would have been difficult to interpret and would have been called indeterminate.

However, his first scan was from 2017, which showed a classic non-fibrotic BIP pattern, suggestive of hypersensitivity pneumonitis.

2020 showed progression to fibrosis and since then scans of 2023, 2024 and 2025 and now 2026 have shown progression. Irrespective of etiology, now this is a progressive pulmonary fibrosis and a biologic behavior that shows progression every year despite being on anti-fibrotics.

The video is a run-through the case on Osirix with all 6 scans shown together, scrolling back and forth to demonstrate the signs and the temporal evolution and progression

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BIP Pattern with PPF - 9 Years Follow Up of Hypersensitivity Pneumonitis

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Bhavin Jankharia