An Autopsy Case of Acute Diffuse Interstitial Fibrosis of the Lungs, with Special Reference of Its Nature

A farmer, 72 years of age, was admitted to the hospital on March 15, 1957, complaining of severe cough and dyspnea. He had had bronchial asthma at 17 years of age from which he had completely recovered. From one and a half year before admission, the patient became to be attacked by severe cough, when he moved his body. Since that time, he received chemotherapy under the diagnosis of pulmonary tuberculosis. But, the therapy had no effect and the syniptoms such as cough and dyspnea increased with lapse of time repeating temporary remissions. On physical examination, at admission, the patient was undernourished and was in anguish. His lips, ear laps, fingers and toes were cyanotic. There was aphthous stomatitis. Temperature 37.6" ; pulse 80; respirations 35. Apex beat of the heart was one finger breadth outside the left mamillary line. The percussion note was impaired presenting dullness all over the right back and showed tympanitic resonance in other parts of both lung fields. The moist rales were heard from the lower lateral to back lower portions of the right lung. The crepitations were heard at the front upper parts of both lungs and the whistlings at the front lower portion of the right lung. The chest roentgenogram disclosed diffusely homogeneous shadows throughout the right lung fields, of which central part was slightly brighter than the other part and presented granular opacities and reticular shadowing. The left lung fields, especially middle and lower fields, showed remarkably streaky and nodular opacities presenting reticular architecture. The liver edge was palpable one finger breadth below the costal margin. There was no ascites, but marked edema of the extremities. R. B. C. 5 . 0 5 ~ lo6 ; Hb 106% ; W. B. C. 17,900; metamyelocytes 2%, band forms 29%, segmented forms 60%, monocytes 2%, lymphocytes 7%. Toxic granules were observed in leucocytes. The sedimentation rate was 103-115. The tuberculin test was negative. Occult blood of the feces was positive. Candida was discovered in the feces and