0:00

Another example of NSIP here.

0:02

And so this is pretty classic for NSIP,

0:05

but I'll tell you, I feel like there may have been more

0:08

organized pneumonia early on, earlier ct,

0:11

which we don't have access to,

0:13

but one of the main findings here,

0:14

we see wrong less opacity,

0:16

which clearly is BAS or predominant.

0:18

And the lung base is there's at least relative,

0:21

if not complete subpleural sparing mild traction

0:24

bronchiectasis within that lung parenchyma.

0:27

And so when you see areas of peri lobular predominance

0:31

of pulmonary opacity, let's go ahead and blow that up.

0:33

This is about your beautiful example

0:34

here in the left lower lobe.

0:36

When you see these areas of peri lobular opacity, so

0:40

around the margins of secondary pulmonary lobules like this,

0:42

like arcades of pulmonary opacity

0:45

or consolidation like this,

0:47

you should be thinking about organizing pneumonia.

0:48

This very commonly gonna be organizing pneumonia in there,

0:52

but there's not much of it, not much consolidation.

0:54

So to me, this looks like a treated case

0:58

of organized pneumonia with NSIP.

1:01

And so the NSIP, even

1:03

after corticosteroids oftentimes will stick around.

1:05

It's not as steroids sensitive as opposed to the majority

1:09

of cases of organized pneumonia steroids,

1:11

corticosteroids just melted away.

1:13

It's actually pretty amazing. And so this is pretty common

1:17

evolution of another myositis case.

1:21

So patients with Dimmy Polymyositis anti syndrome,

1:24

it'll present like that case I showed you before,

1:27

but then when they heal

1:28

after corticosteroids, very commonly you're left

1:30

with this type of wispy pattern.