Fig. 1

HRCT and surgical lung biopsy of a 45-year-old never-smoking woman. a Computed tomography scan shows traction bronchiectasis, reticulation predominantly in the peribronchovascular zone, and a low attenuation area (circle) in the subpleural area of both lower lungs. b Pathologic specimen (H & E staining, × 40) shows fibrotic nonspecific interstitial pneumonia with emphysematous change (grade 2). c At high-power magnification, emphysematous change occurs at the fibrously thickened alveolar walls showing an increase in pores (arrows) (Elastica van Gieson staining, × 100); AD: alveolar duct. d Muscular pulmonary artery shows intimal thickening (grade 1) (Elastica van Gieson staining, × 80). e Pulmonary arteriole lying along the alveolar ducts shows intimal thickening and muscularisation (Elastica van Gieson staining, × 200). f A venule shows intimal thickening and muscularisation (Elastica van Gieson staining, × 200)