Fig. 2

Discrepancy. A 13-year-old male patient with a history of pigeon-feeding presented at the Pediatric Department with the complaint of dyspnea. Clinicians suspected “hypersensitivity pneumonitis” as the first differential. The patient was hospitalized for further management. Serological tests proved the presence of antibodies against specific avian proteins. Thorax CT showed multiple ground-glass nodules (red arrows, a, b). A radiologist interpreted these nodules in favor of "hypersensitivity pneumonia" considering the clinician’s opinion, patient history and serological test results. According to another radiologist, pulmonary veno-occlusive disease was more likely, because of accompanying interlobular septal thickening (blue arrows, a, b), increased pulmonary artery diameter (c) and right ventricular dilatation (d). Although the radiologists were aware of each other’s opinions, both had plausible and supportive arguments for their provisional diagnosis. After a brief discussion, both possibilities were mentioned in the report, but both radiologists thought their own diagnosis was correct. After evaluating both possibilities in the multidisciplinary meeting, it was decided how to proceed with patient management