Cases by Disease Category
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Case No : 1116 Date 2019-03-18
- Courtesy of Bo Mi Gil, Myung Hee Chung / Bucheon St. Mary
- Age/Sex 80 / M
- Chief ComplaintNo specific symptom
Discussion
Diagnosis With Brief Discussion
- Diagnosis
- Chronic eosinophilic pneumonia
- Radiologic Findings
- Initial chest PA showed bilateral patchy or peripheral consolidations and GGOs in the both lung fields.
Chest CT showed multifocal, patchy consolidations with internal air bronchograms and surrounding GGOs in the entire lung fields. Lesions were more peripheral with upper lobar predominance. Our differential diagnosis was chronic eosinophilic pneumonia, cryptogenic organizing pneumonia, and Churg-Strauss syndrome.
VATS wedge resection was done in the right lower lobe. Pathologic findings were acute and chronic inflammation with eosinophilic infiltration in the interstitium and intraalveolar areas with fibrosis.
Steroid treatment was started and then taken FU CXR after 3months shows almost regression.
- Brief Review
- CEP is an idiopathic condition characterized by chronic and progressive clinical features and an abnormal, marked accumulation of eosinophils in the interstitium and alveolar spaces of the lung. The 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.
The typical chest radiographic finding in CEP is nonsegmental peripheral airspace consolidation (photographic negative shadow of pulmonary edema) involving mainly the upper lobes.
CT demonstrates typical nonsegmental areas of airspace consolidation
with peripheral predominance. Less common findings include ground-glass
opacities, nodules, and reticulation. CT performed more than 2months after the onset of symptoms shows linear band-like opacities parallel to the pleural surface, whereas in Cryptogenic organizing pneumonia(COP), consolidation involving subpleural and peribronchial areas was the most common finding with somewhat lower lobar dominancy. Also, bronchial dilatation within the consolidative or GGO lesion was seen significantly more often in COP than in CEP.
- Please refer to Case 163, Case 281, Case 323, Case 369, Case 806, Case 1064, Case 1085,
-
KSTR Symposium 1999 Case 3
,
KSTR Imaging Conference 2016 Spring Case 12 ,
KSTR imaging conference 2018 Spring Case 7,
- References
- 1) Adam Bernheim, Theresa McLoud. A Review of Clinical and Imaging Findings in Eosinophilic Lung Diseases. AJR 2017; 208:1002
- Keywords
No. of Applicants : 91
- ▶ Correct Answer : 56/91, 61.5%
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- - The University of Kyoto Hospital , Japan TOMOAKI OTANI
- - ZIGONG TCM HOSPITAL OF CHINA , China Cao Cunyou
- - Showa University Fujigaoka Hospital , Japan KYOKO NAGAI
- - Ajou University Hospital , Korea (South) SUNG HYUN AN
- - Higashi-Ohmi General Medical Center , Japan AKITOSHI INOUE
- - Chungbuk National University Hospital , Korea (South) YEONGTAE PARK
- - Chonbuk National University Medical School , Korea (South) HYEJIN YANG
- - Ajou University School of Medicine , Korea (South) JUNG YONG JUN
- - Chonbuk National University Hospital , Korea (South) MINGI SHIN
- - McGill University Health Center , Canada Alexandre Semionov
- - Asan Medical Center , Korea (South) EUNJI CHOI
- - Chungbuk National University Hospital , Korea (South) JIYUN KANG
- - Vita Hospital , Brazil DIOGO LAGO PINHEIRO
- - Ajou University Hospital , Korea (South) KYUNGMIN LEE
- - DELTA CARE HOSPITAL, THANJAVUR, INDIA , India SIVARAJA SUBRAMANIAM
- - Chungbuk National University Hospital , Korea (South) CHANGHOON OH
- - Asan Medical Center , Korea (South) YURA AHN
- - istanbul , Turkey AYHAN YILMAZ
- - The Jikei university , Japan TAKU GOMI
- - university of montreal , Canada Andrei Bogdan Gorgos I
- - Fujieda Municipal General Hospital , Japan HAYATO NOZAWA
- - The University of Tokyo Hospital , Japan TOSHIHIRO FURUTA
- - Myongji Hospital , Korea (South) KI EON KWON
- - Narayana Multispeciality Hospital Jaipur Rajasthan , India JAINENDRA JAIN
- - Asan Medical Center , Korea (South) JOOAE CHOE
- - Gifu University Hospital , Japan Yo Kaneko
- - Seoul National University Hospital , Korea (South) JI HEE KANG
- - Samsung Medical Center , Korea (South) MIN YEONG KIM
- - Ajou University Hospital , Korea (South) DAYOUNG KIM
- - Mallinckrodt Institute of Radiology , United States Naganathan BS Mani
- - Diskapi Yildirim Beyazit Hospital, Ankara , Turkey MERIC TUZUN
- - University of Tsukuba, Dept of Radiology , Japan MANABU MINAMI
- - Gyeongsang National University Hospital , Korea (South) KWON HWANWOONG
- - Ajou University Hospital , Korea (South) HYERIN KIM
- - Chungbuk national university hospital , Korea (South) Miran Yeon Yeon
- - Seoul National University Hospital , Korea (South) SE WOO KIM
- - Azienda Ospedaliera di Cremona , Italy Pietro Sergio
- - Chonbuk National University Hospital , Korea (South) KUM JU CHAE
- - Asan Medical Center , Korea (South) JIHOON KIM
- - , Korea (South) JANG SEONG WON
- - Lilavati Hospital , India Pralhad Prabhakar Prabhudesai
- - Korea University Guro Hospital , Korea (South) KYU-CHONG LEE
- - Kizawa Memorial Hospital , Japan Shoji Okuda
- - Chonbuk National University Hospital , Korea (South) MINJEE KIM
- - Ajou University Hospital , Korea (South) SUBIN HEO
- - Kyoto Prefectural University of Medicine , Japan TADASHI TANAKA
- - Ichinomiya Nishi Hospital , Japan Takao Kiguchi
- - National Center for Global Health and Medicine , Japan HIROSHI TAKUMIDA
- - College of Medicine, CHA University , Korea (South) PARK JONG WON
- - Hamamatsu University Hospital , Japan YUKI HAYASHI
- - Diagnose.me (BV) / Royal Perth Hospital , Australia YURANGA WEERAKKODY
- - Chonnam National University Hwasun Hospital , Korea (South) JONG EUN LEE
- - the first affiliatited hospital of nanjing medical univercity , China HAI XU
- - Ajou University Hospital , Korea (South) YONG HO JANG
- - Seoul Veterans Hospital , Korea (South) HYUN JUNG YOON
- - Jiangsu province hospital , China WANGJIAN ZHA
- ▶ Correct Answer as Differential Diagnosis : 24/91, 26.4%
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- - Kinki University Faculty of Medicine, , Japan MITSURU MATSUKI
- - dayanand , India REENA GUPTA
- - NIMS, HYDERABAD , India BHASKAR K
- - Ondokuz Mayis University , Turkey CETIN CELENK
- - Chonbuk National University Hospital , Korea (South) EUN HA JUNG
- - Gyeongsang National University Hospital , Korea (South) HWANGHEE JO
- - Other , Korea (South) SEONGSU KANG
- - Seoul National University Hospital , Korea (South) Ju Gang Nam
- - Oita University, Faculty of Medicine , Japan Fumito Okada
- - Chonbuk National University Hospital , Korea (South) JUNGHWAN KIM
- - Yeungnam University Medical Center , Korea (South) JONGSOO PARK
- - Intermed Hospital , Mongolia KHULAN KHURELSUKH
- - 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
- - CLINIQUE STE CLOTILDE , Reunion PATRICK MASCAREL
- - Inje University Pusan Paik Hospital , Korea (South) MINHA KWAG
- - TB centre kasaragod. , India rikhy krishnan
- - University of Tsukuba Hospital , Japan SODAI HOSHIAI
- - Chonbuk National University Hospital , Korea (South) SOL KI KIM
- - Teikyo University Hospital , Japan KAORU SUMIDA
- - Chonbuk National University Hospital , Korea (South) DONG HAN SHIN
- - Private sector , Greece VASILIOS TZILAS
- - Japanese Red Cross Wakayama Medical Center , Japan AKIHIKO SAKATA
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