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29/F, She complained of progressive dyspnea. She took herb medicine a few days ago.
29岁，女性。主诉：进行性呼吸困难，几天前服用草药。
At admission, chest radiograph shows ill-defined increased opacities, in predominantly both lower lung zones.
入院时，胸片显示边界不清的高密度影，主要以两下肺为主。
After 1day later, density and extent of lesions were more extended and endotracheal tube was inserted in trachea.
1天后，病灶密度及范围更加扩大，气管插管中。
HRCT images represent ill-defined ground glass opacities with interlobular septal thickenings in both lungs and ill-defined areas of consolidations in both lower lobes.
HRCT显示双肺边界不清的磨玻璃影伴小叶间隔增厚，及两肺下叶边界不清的实变。
Acute Hypersensitivity Pneumonitis
急性过敏性肺炎
The initial differential diagnoses were acute interstitial pneumonia, Pneumocystis jiroveci pneumonia, and diffuse alveolar hemorrhage. In BAL fluid, lymphocystosis (67%) was found.
最初鉴别诊断为急性间质性肺炎、肺孢子虫肺炎和弥漫性肺泡出血。在BAL液（支气管肺泡灌洗液）中发现淋巴结增生（67%）。
A section of a transbronchial lung biopsy specimen shows a cellular infiltrate composed predominant lymphocytes, accompanied by variable numbers of epitheliod histiocytes, plasma cells, and eosinophils.
经支气管肺活检标本切片显示淋巴细胞为主的细胞浸润，伴有不同数目的上皮组织细胞、浆细胞和嗜酸性粒细胞。
She had a history of same symptom associated with herb medication three years ago.
三年前，她服用草药后出现相似症状。
The term hypersensitivity pneumonitis (extrinsic allergic alveolitis) denotes a group of disease characterized by an abnormal immunologic reaction in the lung to specific antigens in a wide variety of organic dusts.
过敏性肺炎（外源性过敏性肺泡炎）是指以肺部对多种有机粉尘中特异性抗原的异常免疫反应为特征的一组疾病。
Diagnosis must be suspected primarily on the basis of the clinical history, and meticulous may be required to uncover an exposure coincident with the development of acute respiratory symptoms.
主要根据临床病史进行可疑诊断，并需仔细发现与急性呼吸道症状进展同步的暴露。
Histologic appearance consists of a combination of bronchiolitis and aveolitis with granuloma formation.
组织学表现包括细支气管炎和肺泡炎伴肉芽肿形成。
The radiologic findings vary with the stage of the disease.
放射学表现随疾病分期而变化。
Early in the course of the acute stage, the chest radiograph may show no abnormality, even in patients who have florid pathologic changes on lung biopsy.
在急性期早期，胸片显示正常，即使肺活检的病理改变很严重。
Later on, the characteristic finding consists of bilateral areas of consolidation, which may be diffuse or involve mainly the lower lung zones.
随后，特征性发现包括双肺实变，可弥漫或主要累及下肺。
Hypersensitivity：过敏，高灵敏度
Hyper（超过，太多）+sensitivity（敏感)
progressive dyspnea：进行性呼吸困难
extrinsic：外源性的
allergic [əˈlɜ:dʒɪk] adj.过敏的;
immunologic reaction：免疫反应
granuloma [ˌgrænjʊ'ləʊmə] n.肉芽肿
pneumonitis [nju:məʊ'naɪtɪs] n.肺炎
感谢Woon-Jung Kwon, Ae Kyung Jeong / Department of Diagnostic Radiology, Ulsan University Hospital
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