A 66-year-old woman with abnormal CXR

mycotic aneurysm 으로 anti 4 주간 치료 중이던 환자이며 LGL lymphoma 로 MTX 1 주간격으로 2 회 치료 받았던 환자로 neutropenic fever 발생하면서 CXR 악화 급격히 진행됨 .

Multifocal patchy opacities on the both lungs

TBLB biopsy

Interstitial thickening due to fibroblastic proliferation and intraalveolar fibrinous exudate, consistent with diffuse alveolar damage

Interstitial thickening due to fibroblastic proliferation and intraalveolar fibrinous exudate, consistent with diffuse alveolar damage

Interstitial thickening due to fibroblastic proliferation and intraalveolar fibrinous exudate, consistent with diffuse alveolar damage

GMS stain: several cyst-form microorgnaisms in alveolar spaces

Imunostain of pneumocystis pneumonia antigen

DAD associated with pneumocystitis pneumonia