Radiograph of 65 year old male patient who is know case of Usual interstitial pneumonitis (UIP) showing bilateral reticular shadows (arrow heads) with well deifned soft tissue density lesion in the left upper lobe perihiar region.
CT scan at the level of arch of aorta showing heterogenpusly enhancing lesion in the left upper lobe (arrow) and HRCT lung window showing reticular shadows with honey combing (arrow head). CT guided biopsy of the lesion showed non small cell bronchogenic carcinoma.
Studies have showed that the Usual interstitial pneumonia (UIP), or idiopathic pulmonary fibrosis (IPF), has been considered to be associated with a high risk for lung carcinoma. It is more common in males probably due to smoking.
The nodule or mass in a patient with UIP should be evaluated properly. CT and CT-PET are the preferred modalities. If requred CT guidded biopsy has to be done to confirm the diagnosis. As small as 1 cm nodule can be sampled with CT guidence.
Most of the carcinomas will be peripheral in patients with UIP unlike our case. The diseased lung (UIP) surrounding the nodule/mass can cause pneumothorax during biopsy should be taken care meticulously.