CLINICAL INFORMATION

History of Present Illness

A 71-year-old white male with an active lifestyle noted progressive dyspnea on exertion for the two years prior to evaluation.

The patient was able to exercise and walk at a fast pace; however, in the past two years his pace has slowed and his maximal distance declined.

Currently he has difficulty with activities that were normal for him, such as dancing or mowing the lawn.

Additional Data

Pulmonary function studies eight months prior to biopsy revealed some reactive airways disease. The patient used bronchodilators irregularly, without much relief of symptoms.

One year prior to biopsy, the patient developed an episode of “pneumonia” with fever, chills, and sweats. He was hospitalized for six days. The chest x-ray at that time was abnormal, with evidence of diffuse bilateral interstitial infiltrates.

The patient has no pets, smoked briefly during his youth for less than one year (1½ packs per day maximum), and drinks socially. He worked for 1 year during his 20s in an open-pit mine without protective gear.

Physical Exam

Height: 5'10"
Weight: 238 lbs
Blood pressure: 130/80
HR: 70
RR: 22
Temp: 96.9°
Pulse ox: 93% on room air