We are excited to start the month off with a new #RadiologyRounds
A young adult man in his 20s presents with dyspnea on exertion, productive cough, intermittent wheezing and general fatigue. A chest x-ray was obtained as part of his work-up.
![](https://www.pulmpeeps.com/wp-content/uploads/2024/05/1.jpeg)
![](https://www.pulmpeeps.com/wp-content/uploads/2024/05/2-1024x428.png)
You can identify hyperinflation, interstitial changes and bronchial wall thickening on this image with concern for associated bronchiectasis
![](https://www.pulmpeeps.com/wp-content/uploads/2024/05/3.jpeg)
![](https://www.pulmpeeps.com/wp-content/uploads/2024/05/4-1024x486.png)
You should have Sarcoidosis, Cystic Fibrosis (CF), Hypersensitivity Pneumonitis (HP) and Lymphangioleiomyomatosis (LAM) on the differential
![](https://www.pulmpeeps.com/wp-content/uploads/2024/05/5.jpeg)
A CT chest is obtained given his abnormal chest x-ray and representative images are shown below
![](https://www.pulmpeeps.com/wp-content/uploads/2024/05/6.jpeg)
![](https://www.pulmpeeps.com/wp-content/uploads/2024/05/7-1024x518.png)
Given upper lobe bronchiectasis you are concerned for cystic fibrosis. A sweat chloride test is obtained and was elevated suggesting CF and further genetic testing was sent to confirm the diagnosis.
![](https://www.pulmpeeps.com/wp-content/uploads/2024/05/8-1024x1004.jpeg)