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Weekly Chest CasesArchive of Old Cases

Case No : 1085 Date 2018-08-13

  • Courtesy of Song Soo Kim, MD. / Chungnam National University College of Medicine
  • Age/Sex 64 / M
  • Chief ComplaintCough and dyspnea
  • Figure 1
  • Figure 2
  • Figure 3

Diagnosis With Brief Discussion

Diagnosis
Chronic eosinophilic pneumonia
Radiologic Findings
Chronic eosinophilic pneumonia is one of eosinophilic lung diseases of unknown cause. It is idiopathic condition characterized by chronic and progressive clinical features.
Clinical manifestation is usually insidious and the patient experiences symptoms for an average of 7.7 months before the diagnosis is made. Most patients are middle aged, and approximately 50% have asthma. Women are more frequently affected than men. Pulmonary function tests can be normal in mild cases but usually show restrictive defects. Peripheral blood eosinophilia is usually mild or moderate but occasionally is severe. Increased serum IgE levels are seen in two-thirds of patients. The erythrocyte sedimentation rate is usually elevated and peripheral blood thrombocytosis has also been reported. The percentage of eosinophils in the BAL fluid is very high.
The typical chest radiographic finding in CEP is nonsegmental peripheral airspace consolidation (“photographic negative shadow of pulmonaryedema”) involving mainly the upper lobes. However, this finding may be seen in less than 50% of cases.
CT demonstrates typical nonsegmental areas of airspace consolidation with peripheral predominance. Less common findings include ground-glass opacities, nodules, and reticulation. These less common findings predominate in the later stages of CEP. CT performed more than 2 months after the onset of symptoms shows linear bandlike opacities parallel to the pleural surface. Pleural effusion is observed in less than 10% of cases.
Brief Review
References
Keywords
Lung, Eosinophilic lung disease,

No. of Applicants : 97

▶ Correct Answer : 55/97,  56.7%
  • - Juntendo University , Japan SHOHEI FUJITA
  • - Ishikawa Matto Central Hospital , Japan MANABU AKIMOTO
  • - Saitama-Sekishinkai Hosptal , Japan MIHOKO YAMAZAKI
  • - Showa University Fujigaoka Hospital , Japan KYOKO NAGAI
  • - , Japan SHIMPEI KATO
  • - Higashi-Ohmi General Medical Center , Japan AKITOSHI INOUE
  • - Vita Hospital , Brazil DIOGO LAGO PINHEIRO
  • - Seoul National University Hospital , Korea (South) Ju Gang Nam
  • - Beaulieu clinic Geneva , Switzerland GILLES GENIN
  • - Samsung Medical Center , Korea (South) JUHYUN KIM
  • - The Jikei university , Japan TAKU GOMI
  • - Onomichi municipal hospital , Japan Hirofumi Mifune
  • - Fujieda Municipal General Hospital , Japan HAYATO NOZAWA
  • - Hpital Marie lannelongue , France, Metropolitan PAULINE PRADERE
  • - The University of Tokyo Hospital , Japan TOSHIHIRO FURUTA
  • - HHS , Canada S LEE
  • - Narayana Multispeciality Hospital Jaipur Rajasthan , India JAINENDRA JAIN
  • - Seoul National University Hospital , Korea (South) JI HEE KANG
  • - Samsung Medical Center , Korea (South) MIN YEONG KIM
  • - Dong-A University, College of Medicine , Korea (South) KI-NAM LEE
  • - The University of Tokyo Hospital , Japan RYO KUROKAWA
  • - Chonbuk National University Hospital , Korea (South) YOUNGKWANG LEE
  • - Medicheck health care , Korea (South) Chae hun Lim
  • - National Taiwan University Hospital Hsin-Chu Branch , Taiwan LI-TA KENG
  • - the first affiliated hospital with Nanjing Medical University,China , China JIANJUAN LOU
  • - Mallinckrodt Institute of Radiology , United States Naganathan BS Mani
  • - CLINIQUE STE CLOTILDE , Reunion PATRICK MASCAREL
  • - Diskapi Yildirim Beyazit Hospital, Ankara , Turkey MERIC TUZUN
  • - University of Tsukuba, Dept of Radiology , Japan MANABU MINAMI
  • - Centre Hospitalier Regional de Lanaudiere , Canada MATTHIEU STORME
  • - Avrasya Hospital/ISTANBUL , Turkey MURAT ULUSOY
  • - eskisehir devlet hastanesi , Turkey MURAT SAHIN
  • - Soonchunhyang University Hospital Seoul , Korea (South) BODA NAM
  • - Maimonides Medical Center , United States NAOMI TWERSKY
  • - Kyoto Prefectural University of Medicine , Japan YOSHIAKI OTA
  • - Chonbuk National University Hospital , Korea (South) KUM JU CHAE
  • - Multimagem Diagn泥˜sticos , Brazil PEDRO PAULO TEIXEIRA E SILVA TORRES
  • - , Korea (South) JANG SEONG WON
  • - Wuhan Union Hospital , China QIGUANG CHENG
  • - TB centre kasaragod. , India rikhy krishnan
  • - Korea University Guro Hospital , Korea (South) KYU-CHONG LEE
  • - The First Affiliated Hospital of Nanjing Medical University , China TENG ZHANG
  • - Kizawa Memorial Hospital , Japan Shoji Okuda
  • - University of Tsukuba Hospital , Japan SODAI HOSHIAI
  • - Kyoto Prefectural University of Medicine , Japan TADASHI TANAKA
  • - Ichinomiya Nishi Hospital , Japan Takao Kiguchi
  • - National Center for Global Health and Medicine , Japan HIROSHI TAKUMIDA
  • - , Korea (South) JONGSUN LEE
  • - College of Medicine, CHA University , Korea (South) PARK JONG WON
  • - Hamamatsu University Hospital , Japan YUKI HAYASHI
  • - Chonnam National University Hwasun Hospital , Korea (South) JONG EUN LEE
  • - , Korea (South) HYUNGYU LEE
  • - Seoul Veterans Hospital , Korea (South) HYUN JUNG YOON
  • - Korea University Ansan Hospital , Korea (South) CHERRY KIM
  • - Jiangsu province hospital , China WANGJIAN ZHA
▶ Correct Answer as Differential Diagnosis : 21/97,  21.6%
  • - The University of Kyoto Hospital , Japan TOMOAKI OTANI
  • - Kinki University Faculty of Medicine, , Japan MITSURU MATSUKI
  • - The University of Tokyo Hospital , Japan Akifumi Hagiwara
  • - National cancer center hospital east , Japan SHIOTO ODA
  • - Chonbuk National University Hospital , Korea (South) MINGI SHIN
  • - McGill University Health Center , Canada Alexandre Semionov
  • - NIMS, HYDERABAD , India BHASKAR K
  • - , India RAMESH DHARAVATH
  • - Other , Korea (South) SEONGSU KANG
  • - Scans world , India PHILSON JOSEPH MUKKADA
  • - SAUC , Kuwait FEDAAELDIN TAHA ELBAYAR
  • - Oita University, Faculty of Medicine , Japan Fumito Okada
  • - Samsung Medical Center , Korea (South) JUNSU CHOE
  • - Gifu University Hospital , Japan Yo Kaneko
  • - The University of Tokyo Hospital , Japan TAKU TAJIMA
  • - Holy Family Hopsital , India RAJESH GOTHI
  • - Teikyo University Hospital , Japan KAORU SUMIDA
  • - , Japan YUMI MAEHARA
  • - Diagnose.me (BV) / Royal Perth Hospital , Australia YURANGA WEERAKKODY
  • - the first affiliatited hospital of nanjing medical univercity , China HAI XU
  • - Hallym University Dongtan Medical Center , Korea (South) KIM AYEON
▶ Semi-Correct Answer : 9/97,  9.3%
  • - ZIGONG TCM HOSPITAL OF CHINA , China Cao Cunyou
  • - King Abdulaziz University Hospital , Saudi Arabia Amr M. Ajlan
  • - Ondokuz Mayis University , Turkey CETIN CELENK
  • - , Saudi Arabia JABER ALI GHAZWANI
  • - Freelance resident in Reunion Island , Reunion Fabien HO
  • - 罹…stanbul , Turkey AYHAN YILMAZ
  • - UZ GASTHUISBERG , Belgium JOHAN COOLEN
  • - , United States MAANSI P
  • - University of New South Wales , Australia RASHID HASHMI
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