Human T-cell lymphotropic virus type 1 (HTLV-1)-associated bronchioloalveolar disorder required differentiation from fibrotic chronic hypersensitivity pneumonitis

We encountered a case of HTLV-1-associated bronchioloalveolar disorder (HABA) that was difficult to distinguish from fibrotic chronic hypersensitivity pneumonitis (CHP). Chest thin-section computed tomography (CT) showed diffuse micronodules and revealed peribronchovascular and perilobular distribut...

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Main Authors: Tomonori Chikasue, MD, Akiko Sumi, MD, PhD, Shuichi Tanoue, MD, PhD, Toshi Abe, MD, PhD, Masaki Tominaga, MD, PhD, Junya Fukuoka, MD, PhD, Kiminori Fujimoto, MD, PhD
Format: Article
Language:English
Published: Elsevier 2022-07-01
Series:Radiology Case Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S1930043322002825
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Summary:We encountered a case of HTLV-1-associated bronchioloalveolar disorder (HABA) that was difficult to distinguish from fibrotic chronic hypersensitivity pneumonitis (CHP). Chest thin-section computed tomography (CT) showed diffuse micronodules and revealed peribronchovascular and perilobular distribution. Further, thickening of the interlobular septa, areas of ground-glass attenuation, traction bronchiectasis/bronchiolectasis, and air trapping were observed. Based on these findings, diseases that cause lymphatic tract abnormalities and fibrotic CHP were considered differential diseases. A surgical lung biopsy was performed, and an HTLV-1 antibody was detected using the Western blot analysis of bronchoalveolar lavage fluid. The final diagnosis of HABA was made through a multidisciplinary discussion.
ISSN:1930-0433