대한흉부영상의학회 Weekly Chest Cases

Case No : 128 Date 2000-04-08

Courtesy of Kun-Il Kim, MD. / Pusan National University Hospital, Pusan, Korea
Age/Sex 23 / M
Chief ComplaintAcute onset of fever, dyspnea and arterial hypoxemia. His WBC count was normal and showed no peripheral eosinophilia at ER. Cardiac evaluation revealed normal.

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Diagnosis With Brief Discussion

Diagnosis: Acute Eosinophilic Pneumonia
Radiologic Findings: Initial chest PA shows diffuse increased interstitial markings and reticular densities in both lungs with bilateral small pleural effusion. Note consolidation in left lower lung zone.

Same-day HRCT shows linear densities by diffuse smooth thickening of interlobular septa, and patchy ground-glass opacities, multiple areas of consolidation in both lungs, and bilateral small pleural effusion.

Initial CBC profile showed no peripheral eosinophilia but was followed by markedly increased eosinophils in peripheral blood one day later.

On second hospital day, bronchoalveolar lavage and transbronchial lung biopsy revealed increased eosinophil counts (~60%) and eosinophilic infiltration in the interstitium and the alveolar space.

On 3rd hospital day, chest radiograph showed marked resolution of pulmonary infiltrates.

His symptoms resolved rapidly without any specific treatment. No corticosteroid was given.
Brief Review: To add some points to brief discussion of case No. 105, peripheral eosinophilia may not be presented in the early phase of the disease. Most patients respond rapidly on corticosteroid, but spontaneous resolution was reported in some patients.
References: 1. Cheon JE, Lee KS, Jung GS, Chung MH, Cho YD. Acute eosinophilic pneumonia: radiographic and CT findings in six patients. AJR 1996;167:1195-1199
2. King MA, Pope-Harman AL, Allen JN, Christoforidis GA, Christoforidis AJ. Acute eosinophilic pneumonia: radiologic and clinical features. Radiology:1997;203:715-719
Keywords: Lung, Eosinophilic lung disease,

No. of Applicants : 51

▶ Correct Answer : 28/51, 54.9%

- 寃쎈
- 寃쎈 沅
- 怨媛李쏀
- 怨源
- 怨
- 怨
- 怨
- 怨듦렐
- 諛
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- 遺理湲곕났
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-
- 源
- 蹂李ъ
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- 諛二쇱
- 源
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- 源誘쇱
- Dr. Jankharia's Imaging Centre Bhavin Jankharia
- Gachon Medical School Gil Medical Center Seo Joon Beom
- Matsuyama Red Cross Hospital, Matsuyama,Japan Shunya Sunami
- Samsung Medical Center Kyung Soo Lee
- Seoul National University Hospital Seong Ho Park
- Stedelijk OLV Ziekenhuis Mechelen, Belgium Ivan Pilate

▶ Semi-Correct Answer : 4/51, 7.8%

- 寃쎈
- 沅諛곗＜
- Hospital de Guipuzcoa San Sebastian Spain Gonzalo Vega-Hazas Porrua
- Hospital General Universitario de Alicante, Spain Juan Arenas

대한흉부영상의학회 Korean Society of Thoracic Radiology

Archive of Old Cases

Case No : 128 Date 2000-04-08

Discussion

No. of Applicants : 51