Unilateral interstitial lung disease in a woman aged 35 years

Description

A woman aged 35 years presented to the respiratory services with a history of asthma and recurrent lower respiratory tract infections. Chest X-ray (figure 1) showed mediastinal shift, volume reduction and increased interstitial markings throughout the right lung. Pulmonary function testing revealed a mixed obstructive and restrictive pattern.

Figure1

Chest X-ray.

CT scan demonstrated the absence of the right main pulmonary artery (figure 2). Collateral supply to the right lung was provided from the enlarged right internal mammary and inferior phrenic arteries (figure 3). Fine reticular peripheral interstitial markings, focal areas of ground glass and bronchiolitis were seen in the right lung (figure 4).

Figure 2

CT thorax showing the absence of the right pulmonary artery.

Figure 3

CT showing enlarged inferior phrenic artery.

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