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

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

Radiology Case Reports (Jul 2022)

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

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

Affiliations

Tomonori Chikasue, MD: Department of Radiology, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan; Corresponding author.
Akiko Sumi, MD, PhD: Department of Radiology, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
Shuichi Tanoue, MD, PhD: Department of Radiology, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
Toshi Abe, MD, PhD: Department of Radiology, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
Masaki Tominaga, MD, PhD: Division of Respirology, Neurology, and Rheumatology, Department of Medicine, Kurume University School of Medicine, Kurume, Fukuoka, Japan
Junya Fukuoka, MD, PhD: Department of Pathology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
Kiminori Fujimoto, MD, PhD: Department of Radiology, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan

Journal volume & issue: Vol. 17, no. 7
pp. 2448 – 2452

Abstract

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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.

Published in Radiology Case Reports

ISSN: 1930-0433 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Medicine (General): Medical physics. Medical radiology. Nuclear medicine
Website: https://www.sciencedirect.com/journal/radiology-case-reports

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