20671919 Visualization

A 21 Age - year Age - old Age male Sex presented Clinical_event with a 2 Duration - year Duration history of progressive Detailed_description shortness Sign_symptom of Sign_symptom breath Sign_symptom on exertion Detailed_description and dry Sign_symptom cough Sign_symptom .
At physical Diagnostic_procedure examination Diagnostic_procedure , auscultation Diagnostic_procedure of the lungs Biological_structure has revealed random Detailed_description wheezes Sign_symptom and coarse Sign_symptom crackles Sign_symptom .
Cardiac Biological_structure auscultation Diagnostic_procedure was normal, and no cyanosis Sign_symptom or peripheral Sign_symptom edema Sign_symptom was observed.
There was no History history History of History smoking History or previous known pulmonary Disease_disorder disease Disease_disorder .
On routine Detailed_description blood Diagnostic_procedure examination Diagnostic_procedure , blood Diagnostic_procedure counts Diagnostic_procedure and serum Diagnostic_procedure chemistries Diagnostic_procedure were found to be normal Lab_value .
Arterial Diagnostic_procedure blood Diagnostic_procedure gas Diagnostic_procedure analysis Diagnostic_procedure and echocardiography Diagnostic_procedure showed no Lab_value important Lab_value abnormalities Lab_value .
Pulmonary Diagnostic_procedure function Diagnostic_procedure tests Diagnostic_procedure ( PFT Diagnostic_procedure ) showed a mild Severity restrictive Sign_symptom ventilatory Sign_symptom defect Sign_symptom , with a reduced Lab_value total Diagnostic_procedure lung Diagnostic_procedure capacity Diagnostic_procedure of 79% Lab_value ( 5.94 Lab_value   L Lab_value ), forced Diagnostic_procedure vital Diagnostic_procedure capacity Diagnostic_procedure of 80% Lab_value ( 4.18 Lab_value   L Lab_value ) and a forced Diagnostic_procedure expiratory Diagnostic_procedure volume Diagnostic_procedure in Diagnostic_procedure one Diagnostic_procedure second Diagnostic_procedure of 83% Lab_value ( 3.72 Lab_value   L Lab_value ).
The sputum Biological_structure was negative Lab_value for acid Diagnostic_procedure - alcohol Diagnostic_procedure resistant Diagnostic_procedure bacillus Diagnostic_procedure and human Diagnostic_procedure immunodeficiency Diagnostic_procedure virus Diagnostic_procedure testing Diagnostic_procedure was negative Lab_value as well.
The chest Diagnostic_procedure plain Diagnostic_procedure films Diagnostic_procedure revealed a diffuse Detailed_description symmetric Detailed_description dense Texture bilateral Biological_structure micronodular Sign_symptom pattern Sign_symptom (Figure 1).
Based on this finding, HRCT Diagnostic_procedure scan Diagnostic_procedure was obtained, revealing diffuse ground Sign_symptom glass Sign_symptom attenuation Sign_symptom and septal Sign_symptom thickening Sign_symptom , more pronounced in lower Biological_structure pulmonary Biological_structure regions Biological_structure , with calcifications Sign_symptom along the interlobar Biological_structure septa Biological_structure and subpleural Biological_structure regions Biological_structure .
Subpleural Biological_structure cysts Sign_symptom were also noticed (Figure 2).
The patient underwent a fiberoptic Diagnostic_procedure bronchoscopy Diagnostic_procedure with bronchoalveolar Diagnostic_procedure lavage Diagnostic_procedure and transbronchial Biological_structure lung Biological_structure biopsy Diagnostic_procedure .
The lavage Biological_structure fluid Biological_structure was negative Lab_value for tuberculosis Diagnostic_procedure or fungi Diagnostic_procedure .
Microliths Sign_symptom were not found.
Histology Diagnostic_procedure revealed round Shape , concentrically Detailed_description laminated Detailed_description microliths Sign_symptom in the alveoli Biological_structure associated with slightly Severity thickened Sign_symptom interstitial Sign_symptom septa Sign_symptom , consistent with the diagnosis of PAM Disease_disorder .