Our patient’s HRCT showed several, approximately 5-mm, well-demarcated noncalcified nodules predominantly in the lung bases, and a small right pleural effusion, findings compatible with those previously described in the literature. However, there also were mosaic areas of GGO diffusely in both lungs and interlobular septal thickening, and airspace disease predominantly within the left lower lobe. Mukundan and colleagues1
reported GGO as well as interlobular septal thickening on HRCT in one patient with pulmonary EHE; in their patient, GGO and interlobular septal thickening predominated, mimicking the appearances of diffuse interstitial lung disease, and nodules were not present. They attributed the atypical radiologic appearance to the pathologic finding of small and infiltrating nodular tumor proliferation within the lumen of arteries and veins, rather than the more typical pattern of interstitial nodules. To our knowledge, our patient’s HRCT findings represent the first reported case of pulmonary EHE with both typical CT features such as multiple nodules and pleural effusions, and less typical CT features such as GGO and interlobular septal thickening. Airspace disease is not previously described.