Radiological and Pathological Correlation in Anti-MDA5 Antibody-positive Interstitial Lung Disease: Rapidly Progressive Perilobular Opacities and Diffuse Alveolar Damage

Haruka Chino; Akimasa Sekine; Tomohisa Baba; Tae Iwasawa; Koji Okudela; Tamiko Takemura; Harumi Itoh; Shinji Sato; Yasuo Suzuki; Takashi Ogura

doi:10.2169/internalmedicine.55.5774

CASE REPORTS

Radiological and Pathological Correlation in Anti-MDA5 Antibody-positive Interstitial Lung Disease: Rapidly Progressive Perilobular Opacities and Diffuse Alveolar Damage

Haruka Chino, Akimasa Sekine, Tomohisa Baba, Tae Iwasawa, Koji Okudela, Tamiko Takemura, Harumi Itoh, Shinji Sato, Yasuo Suzuki, Takashi Ogura

Author information

Haruka Chino
Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, Japan
Akimasa Sekine
Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, Japan
Tomohisa Baba
Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, Japan
Tae Iwasawa
Department of Radiology, Kanagawa Cardiovascular and Respiratory Center, Japan
Koji Okudela
Department of Pathology, Yokohama City University Graduate School of Medicine, Japan
Tamiko Takemura
Department of Pathology, Japanese Red Cross Medical Center, Japan
Harumi Itoh
Biomedical Imaging Research Center, University of Fukui, Japan
Shinji Sato
Division of Rheumatology, Department of Internal Medicine, Tokai University School of Medicine, Japan
Yasuo Suzuki
Division of Rheumatology, Department of Internal Medicine, Tokai University School of Medicine, Japan
Takashi Ogura
Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, Japan

Keywords: rapidly-progressive interstitial lung disease, clinically amyopathic dermatomyositis, anti-melanoma differentiation-associated protein 5 antibody, surgical lung biopsy, radiological and pathological correlation, perilobular opacities

JOURNAL OPEN ACCESS

2016 Volume 55 Issue 16 Pages 2241-2246

DOI https://doi.org/10.2169/internalmedicine.55.5774

Details

Abstract

We herein present the first case of rapidly progressive interstitial lung disease (RP-ILD) with anti-melanoma differentiation-associated protein 5 (MDA5) antibody evaluated by surgical lung biopsy (SLB). High-resolution CT scan revealed perilobular opacities, which rapidly became thicker and formed consolidation, resulting in remarkable loss of lung volume. Specimens taken from SLB revealed membranous organization with alveolar occlusion, dilation of alveolar ducts, and sacs with collapsed alveoli, which are typical features of diffuse alveolar damage (DAD). Rapidly progressive perilobular opacities may be characteristic of RP-ILD with anti-MDA5 antibody and DAD.

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