case_images: PMC11127763_01
case_images: PMC11127763_02
case_images: Chest CT images show progressive pleural and pulmonary fibrosis/scarring consistent with PPFE: ((a) 2015 (at the time of discharge), (b) 2017, (c) 2018, (d) 2019, (e) 2020, (f) 2021, and (g) 2022 (at the age of 9 years)). CT image shows pleural thickening (red arrow heads) and bronchiectasis (white arrow), a reticular shadow (blue arrows) localized in the bilateral upper lobes predominant. Pectus excavatum (yellow arrows) is also observed.
case_images: CRIPE2024-4352032.001.jpg
case_images: PMC11127763_02_CRIPE2024-4352032.001.jpg
case_images: fig1
case_images: Two years after onset, follow-up chest computed tomography (CT) showed thickening of the pleura in the bilateral upper lobes although she did not show any symptoms (Figures 1(a) and 1(b)). CT demonstrated pectus excavatum, pleural thickening, and a reticular shadow in the bilateral upper lobes (Figures 1(a)-1(g)).
case_images: (a) Chest radiography at 2 years of age (at the time of discharge). (b) Mediastinal shift to the left side due to the volume loss of left lung (red arrows) at the age of 9 years.
case_images: CRIPE2024-4352032.002.jpg
case_images: PMC11127763_02_CRIPE2024-4352032.002.jpg
case_images: fig2
case_images: During the next 5 years, regular chest roentgenogram revealed increased pulmonary infiltrates, volume loss predominantly in the upper lung, pleural thickening, and severe mediastinal shift (Figures 2(a) and 2(b)).
case_images: She demonstrates pectus excavatum at the age of 9 years.
case_images: CRIPE2024-4352032.003.jpg
case_images: PMC11127763_02_CRIPE2024-4352032.003.jpg
case_images: fig3
case_images: Physical examination demonstrated pectus excavatum which was not evident at a diagnosis of NB (Figure 3).
case_images: Thoracoscopy shows left upper lobe-predominant subpleural and perilobular fibrosis (red arrow heads). There was no evidence of pleural thickening or inflammatory changes in the parietal pleura (white arrow).
case_images: CRIPE2024-4352032.004.jpg
case_images: PMC11127763_02_CRIPE2024-4352032.004.jpg
case_images: fig4
case_images: There was no evidence of pleural thickening or inflammatory changes in the parietal pleura at thoracoscopy (Figure 4).
case_images: PMC11127763_03