대한흉부영상의학회 Weekly Chest Cases

Case No : 180 Date 2001-04-07

Courtesy of Ki-Nam Lee, M.D., Seong Kuk Yoon, M.D. / Dong-A University Hospital, Pusan, Korea
Age/Sex 39 / M
Chief ComplaintIncidental solitary pulmonary nodule detected on chest CT. The second CT image obtained 1 month later shows complete disappearance of the nodule.

Figure 1
Figure 2

Diagnosis With Brief Discussion

Diagnosis: Simple pulmonary eosinophilia (Loeffler's syndrome)
Radiologic Findings: Chest CT shows a small nodule with surrounding ground glass opacity (CT halo sing) in left lowe lobe. Follow-up CT after 1 month shows no visible abnormal nodule.
On admission, blood eosinophil count was elevated (7.8%).
Brief Review: Synonyms for this condition include simple pulmonary eosinophilia and Loeffler's syndrome. The characteristic features of the syndrome are (1) blood eosinophilia, (2) absent or mild symptoms and signs (cough, fever, dyspnea), (3) one or more nonsegmental pulmonary consolidations that are transitory and/or migratory, and (4) spontaneous clearing of consolidations. Originally, opacities were described as disappearing within 6 to 12 days, but this interval is now generally extended to a month, It seems likely that some, if not all of Loeffler' original cases were related to ascariasis.

Loeffler's syndrome may be idiopathic (cryptogenic), or it may result from a variety of inciting agents, particularly drugs, parasites, and miscellaneous agents such as nickel carbonyl. Presentation has been noted to vary seasonally. The prognosis is excellent.

Pathologically, there is an eosinophilic pneumonia with edema and an esosinophilic infiltrate in both alveoli and interstitium. Radiographically the findings are one or more fairly homogeneous, nonsegmental consolidations that can be small or so large as to occupy much of a lobe. They are transitory and may be migratory disappearing from on area and appearing in another. They have a tendency to be peripherally located. Pleural effusion, mediastinal adenopathy, and cavitation are not described.
References: 1. Amstrong P, Winson AG, Dee P, Hnasell DM. Imaging of diseases of the chest, 3rd ed. St. Louis: Mosby, 2000: 587
Keywords: Lung, Eosinophilic lung disease, Parasitic infection,

No. of Applicants : 38

▶ Correct Answer : 29/38, 76.3%

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- 嫄닿뎅
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- 11th Air Force Hospital Byung-June Jo
- CHU Nancy Brabois France Denis Regent
- Seoul City Boramae Hospital Jae-Woo Song
- Seoul National University Hospital Tae Jung Kim
- Seoul National University Hospital Su Kyung An
- Seoul National University Hospital Sung Gyu Moon
- Stedelijk OLV Ziekenhuis Mechelen, Belgium Ivan Pilate

대한흉부영상의학회 Korean Society of Thoracic Radiology

Archive of Old Cases

Case No : 180 Date 2001-04-07

Discussion

No. of Applicants : 38