Interstitial Lung Disease (ILD)
Video Case Study Series


The ATS ILD Video Case Study Series features a panel of ILD experts presenting actual clinical cases in real-time discussion. The video episode showcases unscripted multidisciplinary interactions and discusses actual cases evaluated by regional experts experienced in the management of ILD. Viewers will be able to observe the typical clinical, radiological and pathological features associated with ILD as well as be reminded of the importance of elimination of all known causes and conditions, environmental factors, and connective tissue diseases associated with ILD when evaluating patients.

The goal of the ATS Video Case Study Series is to set clinicians on the right path for an accurate diagnosis, which will prompt the most appropriate interventions and better patient outcomes.

Panel of Experts

Ganesh Raghu, MD Fernando Martinez, MD Jeffrey Myers Sudhakar Pipavath, MD Virginia Steen, MD
Ganesh Raghu, MD
Director, Center of Interstitial Lung Disease, Co-Director Scleroderma Clinic, University of Washington Medical Center, Professor of Medicine, University of Washington
Fernando Martinez, MD
Professor of Medicine, Executive Vice Chair, Cornell University
Jeffrey Myers, MD
A. James French Professor and Director, Divisions of Anatomic Pathology and MLabs University of Michigan
Sudhakar Pipavath, MD
Associate Professor, Department of Radiology, University of Washington
Virginia Steen, MD
Professor of Medicine, Division of Rheumatology, Georgetown University


Episode 1: 82-year-old Man with Exertional Dyspnea: Role of HRCT in Diagnosing IPF
An 82-year-old man with progressive breathlessness is discovered to have characteristic findings of IPF on a high resolution computed tomography (HRCT) of his chest. See how the experts settle the issue of whether the IPF diagnosis is secure in the absence of a surgical lung biopsy.
Episode 2: 43-year-old Woman with Cough: Role of Laboratory Evaluation in Suspected IPF
A 43-year-old woman was discovered to have bibasilar crackles in the course of evaluation for cough. From there the road was complicated by tantalizing exposure histories and an HRCT that seemed to settle the question until unexpected laboratory results changed everything! Learn what experts suggest for routine laboratory evaluation in patients with unexplained diffuse lung disease.
Episode 3: 69-year-old Man with IPF... Or Is It?
A 69-year-old man with a 6 month history of exertional dyspnea and atypical radiologic findings had usual interstitial pneumonia (UIP) on a surgical lung biopsy. The diagnosis of idiopathic pulmonary fibrosis (IPF) was settled until follow-up studies yielded an unanticipated result!
Episode 4: 30-year-old Woman with Cough: Calling the Cryptogenic Organizing Pneumonia (COPs) on Connective Tissue Disease!
A 30-year-old woman with cough was discovered to have bilateral abnormalities on her HRCT that included a string of diagnostic pearls. Surgical lung biopsy cemented the nature of the parenchymal abnormality but it was only after correlation with other laboratory and clinical data that a complete picture emerged.
Episode 5: 52-year-old Woman Develops Acute Onset of Dyspnea After a Road Trip: Unlocking This Mystery Requires Teamwork!
A 52-year-old woman becomes ill after returning from a prolonged absence. Details of her history combined with unexpected findings in a CT angiogram lead to a surgical lung biopsy performed in large part to finalize the diagnosis with a level of certainty required to satisfy this understandably skeptical patient.
Episode 6: 60-year-old Woman With Subacute Onset of Dry Cough and Dyspnea: Recurrence of Disease After a Short Course of Steroids Leads to Final Diagnosis
A 60-year-old woman thought to have cryptogenic organizing pneumonia (COP) after transbronchial biopsy takes an unexpected turn for the worse after tapering her short course of prednisone. See how the experts sort this one out, and what they might advocate for getting to a place of certainty regarding her final diagnosis.
Episode 7: 69-year-old Man With Cough and Exertional Dyspnea: Reconciling an Unusual History with Non-Diagnostic HRCT and The Results of Surgical Lung Biopsy
A 69-year-old man discovered to have an abnormal CT scan in the course of evaluation for angina returns to his normal state of health including vigorous activity with environmental exposures that raise a number of red flags. His lung mechanics look good but his DLco not-so-much. HRCT confirms the presence of diffuse lung disease but without a specific answer. See how the experts work through next steps and ultimately stitch the story, HRCT and surgical lung biopsy results together to yield a final diagnosis.
Episode 8: 61-year-old Woman With Years of Progressive Dyspnea, 40 Pack-Years of Smoking, Clubbing and Crackles: HRCT Makes the Case
A 61-year-old woman with long-standing exertional dyspnea, digital clubbing and a significant smoking history is discovered to have bibasilar crackles in the course of her exam. Screening pulmonary function studies show normal FEV1 and FVC accompanied by a markedly reduced DLco. See how an expert radiologist sorts through the differences between paraseptal emphysema and honeycombing to get to a final diagnosis in this complicated patient.
Episode 9: 31-year-old Woman With Exertional Dyspnea: The Specificity of Nonspecific Interstitial Pneumonia
A 31-year-old previously healthy woman develops progressive dyspnea over a period of just a few months, eventually landing her in a hospital bed. Preliminary pulmonary function studies demonstrated evidence of severe restrictive lung disease. See how an expert panel works through the results of her evaluation, including HRCT and surgical lung biopsy, to get to a place of certainty for a diagnosis that can only be made after careful multi-disciplinary review!
Episode 10: 36-year-old Woman With Cough, Dyspnea and Lung Cysts: A Special Role for Chest Imaging
A 36-year-old woman with a six month history of exertional dyspnea was discovered to have distinctive radiologic findings in the course of her evaluation. See how our multidisciplinary team weights the radiologic findings and balances that over and against any incremental value that might accrue from lung biopsy. A great example of the value of HRCT in patients with diffuse diseases other than IPF!
Episode 11: 56-year-old Man With Two Years of Cough: Reconciling HRCT and Surgical Lung Biopsy Results with A History of Smoking, Birds, and Occupational Exposures
A 56-year-old man with a two year history of cough attributed to COPD was referred for persistent symptoms. He had a complex history that included exposures to cigarette smoke, avian antigens, and work-related toxins. See how an HRCT ultimately followed by surgical lung biopsy were reconciled with his story to yield a final diagnosis through multidisciplinary review.
Episode 12: 54-year-old Woman Who is Well but Worried: The Role of Family History in Patients With Diffuse Lung Disease
A 54-year-old woman with no respiratory complaints seeks expert guidance in the face of a disturbing family history: two siblings recently died of IPF at 40 and 52 years of age, and her mother appears to have died of the same disease at 84 years of age. See how her story unfolds over nearly a decade of follow-up, and whether our expert panel gets to a place of greater certainty regarding her risk for developing IPF.
Episode 13: 49-year-old Woman With Productive Cough, Dyspnea on Exertion and Unexplained Diffuse Lung Disease: The Role of Multidisciplinary Review in Managing the Unclassifiable
A 49-year-old woman complained of two to three years of persistent cough following a URI. An environmental history identified several prime suspects but the HRCT offered little support. See how our panel walks through all of the data after her surgical lung biopsy. Turns out that even after complete evaluation and expert multidisciplinary review there remain unanswered questions.