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Chest Imaging

Acute interstitial pneumonia

(AIP), (also called Hamman Rich syndrome), a fulminant disease of unknown aetiology with histological findings of diffuse alveolar damage; it is sometimes referred to as idiopathic adult respiratory distress syndrome. A prodrome with symptoms of viral infection is often present, followed by rapidly increasing dyspnoea and respiratory failure. Death may occur despite supportive therapy. Pathological abnormalities consist of alveolar wall oedema, inflammation and fibroblast proliferation, with extensive alveolar damage and hyaline membranes. Radiographic and HRCT findings include bilateral, symmetrical areas of ground glass opacity, usually involving all lung zones, bilateral areas of air-space consolidation (Fig.1) and, in some patients, the development of subpleural honeycombing.

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Fig.1

Portable chest radiograph showing patchy air-space consolidation in a patient with pathologically proven AIP.
Acute interstitial pneumonia, Fig.1