July Case of the Month

Clinical History:A 68-year-old woman with a previous history of recurrent bilateral pneumothoraces  presented with shortness of breath. She had no previous smoke exposure. Serology for aspergillus precipitins and antibodies to exclude systemic diseases were negative. Chest high resolution computed tomography showed wedge-shaped bilateral dense reticular subpleural fibrosis with an upper lobe predominance and clear demarcation between the fibrosis and the normal lung. Figures 1-4 are of a surgical lung biopsy. Figures 2 and 4 are stained with an elastic von Giesson stain.

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