A 58-year-old male smoker presents with progressive dyspnoea. CT chest shows bilateral basal-predominant areas of ground-glass opacity with superimposed irregular reticulation, traction bronchiectasis, and honeycombing in the subpleural regions. There is no ground-glass opacity in excess of fibrosis and no peribronchovascular predominance. Which pattern does this CT most closely represent?
- A Non-specific Interstitial Pneumonia (NSIP)
- B Cryptogenic Organising Pneumonia (COP)
- C Usual Interstitial Pneumonia (UIP) ✓
- D Desquamative Interstitial Pneumonia (DIP)
Correct answer: C. Usual Interstitial Pneumonia (UIP)
Explanation
The UIP pattern is characterised by bilateral, basal and subpleural predominant reticulation with honeycombing and traction bronchiectasis; ground-glass opacity is minimal and subordinate to the fibrosis. NSIP shows predominant ground-glass with less honeycombing and a peribronchovascular sparing pattern. COP manifests as peripheral consolidation. DIP presents with diffuse ground-glass in smokers. The described findings are the hallmark CT appearance of UIP, typically seen in Idiopathic Pulmonary Fibrosis.
Reference: Grainger & Allison's Diagnostic Radiology, 7th ed.
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