A 58-year-old male with progressive dyspnea has HRCT showing bilateral basal-predominant reticular opacities, traction bronchiectasis, and honeycombing in a subpleural distribution with no ground-glass opacity predominance. The pattern is MOST consistent with:
- A Nonspecific Interstitial Pneumonia (NSIP)
- B Respiratory Bronchiolitis-ILD
- C Usual Interstitial Pneumonia (UIP) ✓
- D Desquamative Interstitial Pneumonia
Correct answer: C. Usual Interstitial Pneumonia (UIP)
Explanation
The combination of basal-predominant subpleural reticular opacities, traction bronchiectasis, and honeycombing with absent or minimal ground-glass opacity defines the typical UIP pattern on HRCT, which is the radiologic correlate of idiopathic pulmonary fibrosis. NSIP shows predominant ground-glass opacity with peribronchovascular distribution and relative subpleural sparing. RB-ILD and DIP both show predominant ground-glass opacity in smokers, lacking honeycombing.
Reference: Grainger & Allison's Diagnostic Radiology, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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