Figure 4.

The EBUS image of normal lung parenchyma surrounding bronchial structures had patchy and numerous hyperechoic particles that were typically called snowstorm-like. The image represented normal air-filled alveoli (a), an EBUS image of Pneumocystis carinii pneumonia (PCP). The image was from a 46-year-old woman which demonstrates mixed blizzard sign, the internal echo of the lesions demonstrated diffuse heterogeneity with several hyperechoic dots and linear arcs that were distributed irregularly (b). The CT manifestations included bilateral diffuse ground-glass opacity (c). Biopsy was performed at part-solid GGO lesion in the right lower lung lobe, the diagnosis of pneumocystis carinii infection identified by mNGS ((c) black arrow).