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Symptomatic lymphoid interstitial pneumonitis
Definitive diagnosis: Chest.X-ray: bilateral reticulonodular interstitial pulmonary infiltrates present for more than two months with no response to antibiotic treatment and no other pathogen found. Oxygen saturation persistently <90%. Cor pulmonale and increased exercise-induced fatigue. Characteristic histology.
Case 1 a 2-year-old child
 
A chest radiograph of a 2-year-old child shows interstitial infiltrates and reticulonodular patterns.
She had generalized lymphadenopathy
She had hyperemia of the distal part of the fingers (early clubbing of the digits).
Case 2 a 3-year-old child
 
A chest radiograph of a 3-year-old child shows interstitial infiltrates and reticulonodular patterns.

Note:
She also had parotitis and generalized lymphadenopathy.

Case 3 a 4-year-old child
 
A chest radiograph of a 4-year-old child shows interstitial infiltrates and reticulonodular patterns.
She had clubbing of the digits.
Computed tomography of the chest
Hematoxylin-eosin staining of a lung biopsy specimen
demonstrating lymphoid interstitial pneumonitis. Diffuse
infiltration of interstitial and alveolar space by lymphocytes and plasma cells.
The infiltrated lymphocytes are both B cells and T cells with
predominance of T-suppressor cells
 
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