Tuberc Respir Dis.  2007 Jan;62(1):56-61. 10.4046/trd.2007.62.1.56.

A Case of Nonspecific Interstitial Pneumonia in a Patient with Ulcerative Colitis

• Noh YW
• Baik EK
• Ryu YJ
• Kim SE
• Lee JH
• Sim SS
• Lee SN
• Chun EM

• KMID: 1518490
• DOI: http://doi.org/10.4046/trd.2007.62.1.56

Abstract

Pulmonary complications of ulcerative colitis are relatively uncommon and may present as a variety of disorders. Ulcerative colitis-related interstitial lung disease is extremely rare. There are a few case reports of nonspecific interstitial pneumonia in ulcerative colitis worldwide but none in Korea. We report a patient with ulcerative colitis related biopsy-proven nonspecific interstitial pneumonia, who responded to prednisolone (1 mg/kg) and mesalazine therapy

Keyword

Nonspecific interstitial pneumonia; Ulcerative colitis

MeSH Terms

Colitis, Ulcerative*
Humans
Korea
Lung Diseases, Interstitial*
Mesalamine
Prednisolone
Ulcer*
Mesalamine
Prednisolone

Figure

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  Figure 1 Initial Chest PA shows bilateral multifocal ill-defined peripheral dominant consolidations, nodules and reticular opacities (A). Chest PA after 3 months shows improvement of the lesions (B).

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  Figure 2 Lung window of transaxial enhanced CT (1.25-mm collimation) scans done at initial diagnosis, where aortic arch level (A) and right bronchus intermedius level (B) shows irregular shaped nodules, reticular lesions and both upper lobe consolidation with subpleural area (arrows). Lung window scan obtained after 3 months treatment on same level (A) and (B) demonstrating decrease of previous noted (C, D) lesions.

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  Figure 3 Colonoscopic finding shows diffuse erythematous lesions, loss of vascular markings, and fine granular inflammatory lesions, with exudates from rectum to cecum (A-C). Colonoscopic finding repeated after treatment shows interval improvement (D-F) of the lesions.

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  Figure 4 Histologic findings of open lung biopsy. These microscopic findings show mild to moderate chronic interstitial inflammation, containing lymphocytes and a few plasma cells, in a uniformed pattern. Patchy interstitial fibrosis without temporal heterogeneity is present with a few airspace organization. These features are consistent with nonspecific interstitial pneumonia, mixed type (cellular and fibrosing types). (H&E Stain, ×100, A and B)

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  Figure 5 Histologic findings of colonscopic biopsy. Microscopic findings show chronic inflammation with prominent lymphoid aggregates and crypt abscess (H&E Stain, ×400).

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