Dr Romi Singla - Department Of Pulmonary Medicine GMC, Patiala

A 37 year old markedly dyspnoeic man with
rheumatoid arthritis.
(A) Chest radiograph demonstrates
reduced vascularity in the right upper
zone and bronchial wall thickening in
the lower lobes. The suspected
diagnosis was obliterative bronchiolitis.
(B) HRCT in inspiration demonstrates a
mosaic attenuation pattern with normal
parenchyma (arrow) and extensive
areas of reduced vascularity
(arrowheads), highly suggestive of
obliterative bronchiolitis.
(C) HRCT in expiration confirms the
diagnosis by demonstrating air
trapping in the areas of reduced
vascularity (arrowheads).