Differential Diagnosis for Basilar Subpleural Reticular Change with Associated Mild Bronchiolectasis
Single Most Likely Diagnosis
- Idiopathic Pulmonary Fibrosis (IPF): The description of basilar subpleural reticular change with associated mild bronchiolectasis and a probable UIP pattern is highly suggestive of IPF, which is a type of interstitial lung disease characterized by progressive fibrosis of the lung tissue.
Other Likely Diagnoses
- Connective Tissue Disease-associated Interstitial Lung Disease (CTD-ILD): Conditions like rheumatoid arthritis, scleroderma, and lupus can cause interstitial lung disease with a UIP pattern, similar to IPF.
- Chronic Hypersensitivity Pneumonitis (CHP): This condition, resulting from an immune response to inhaled antigens, can also present with a UIP pattern on imaging, although it typically has additional features like mosaic attenuation.
- Asbestos-related Lung Disease: Asbestos exposure can lead to interstitial lung disease with a UIP pattern, along with other characteristic findings like pleural plaques.
Do Not Miss Diagnoses
- Lymphangitic Carcinomatosis: Although less likely, this condition, which involves the spread of cancer to the lymphatic vessels of the lungs, can mimic a UIP pattern and is critical to diagnose due to its implications for cancer staging and treatment.
- Sarcoidosis: While typically presenting with a different pattern, sarcoidosis can occasionally mimic UIP, especially in its advanced stages, and missing this diagnosis could lead to inappropriate treatment.
Rare Diagnoses
- Hermansky-Pudlak Syndrome: A rare genetic disorder that can cause pulmonary fibrosis with a UIP pattern, among other systemic manifestations.
- Neurofibromatosis Type 1 (NF1) associated Lung Disease: NF1 can rarely cause interstitial lung disease, including a pattern resembling UIP.
- Erdheim-Chester Disease: A rare form of histiocytosis that can involve the lungs and mimic interstitial lung disease patterns, including UIP.