부산대학교 도서관

Chronic hypersensitivity pneumonitis (CHP) is a granulomatous disorder. The typical features of CHP include fibrotic changes in the upper or middle lungs on high resolution computed tomography (HRCT) and lymphocyte predominance in the bronchoalveolar lavage (BAL) fluid. In this report, we describe a middle-aged woman presenting with a chronic cough for 2 months. She had a history of exposure to ring-necked pheasants. HRCT revealed reticular opacities and fibrotic change in the bilateral basal lungs. The percentage of neutrophils in the BAL fluid was 75%. She underwent a video-assisted thoracoscopic surgery biopsy and the pathology was consistent with the typical findings of CHP. The patient's symptoms and diffusion capacity responded well to low-dose oral prednisolone treatment, and the follow-up HRCT revealed nearly total resolution of previous lesions. We also review the literature regarding the diagnostic and prognostic impact of atypical presentations of CHP.