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Journal of Thoracic Imaging:
Imaging of Occupational Lung Disease

Clinical and Radiologic Manifestations of Hypersensitivity Pneumonitis

Glazer, Craig S. M.D.*† ; Rose, Cecile S. M.D., MPH*†‡; Lynch, David A. M.D.†§

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Abstract

Hypersensitivity pneumonitis (HP) is an inflammatory interstitial lung disease caused by recurring exposure to a variety of occupational and environmental antigens. It features widely variable clinical, radiologic, and histopathologic findings. Because the clinical findings of HP mimic multiple other diseases, a high degree of clinical suspicion and a thorough occupational and environmental history are essential for accurate diagnosis. There is no single pathognomonic feature for HP; rather, diagnosis relies on a constellation of clinical, radiologic, and pathologic findings. The radiologic manifestations, particularly the high-resolution computed tomography (HRCT) pattern, provide important clues and frequently point clinicians towards the correct diagnosis. The HRCT findings in HP may include ground-glass opacification, centrilobular nodules, air trapping (mosaic pattern), fibrosis, emphysema, or more frequently a combination of these. The combination of a mosaic pattern with ground-glass opacification and centrilobular nodules is particularly suggestive of the diagnosis. The best long-term prognosis is achieved with early diagnosis and removal from exposure.

© 2002 Lippincott Williams & Wilkins, Inc.

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