A 62-year-old woman with no smoking history presents with exertional breathlessness. HRCT shows bilateral, basal-predominant, subpleural honeycombing with traction bronchiectasis and minimal ground-glass opacity. Which diagnosis does this CT pattern most strongly support?
- A Nonspecific interstitial pneumonia (NSIP)
- B Cryptogenic organizing pneumonia (COP)
- C Usual interstitial pneumonia (UIP) / IPF ✓
- D Lymphoid interstitial pneumonia (LIP)
Correct answer: C. Usual interstitial pneumonia (UIP) / IPF
Explanation
Honeycombing with traction bronchiectasis in a bilateral, basal, and subpleural distribution is the hallmark of a UIP pattern on HRCT, which corresponds pathologically and clinically to idiopathic pulmonary fibrosis (IPF). NSIP shows predominant ground-glass opacity with basal subpleural sparing. COP demonstrates consolidation in a peribronchovascular distribution. LIP is characterized by diffuse ground-glass opacity and lung cysts, often in patients with Sjogren syndrome or HIV.
Reference: Grainger & Allison's Diagnostic Radiology, 7th ed.
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Written and medically reviewed by the StethoPrep medical team.