Lung - nontumor - Chronic eosinophilic pneumonia

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Lung-nontumor

Other interstitial pneumonitis / fibrosis

Chronic eosinophilic pneumonia

Reviewers: Elliot Weisenberg, M.D. (see Reviewers page)
Revised: 24 September 2011, last major update September 2011
Copyright: (c) 2003-2011, PathologyOutlines.com, Inc.

Definition
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● Reaction to drugs, Aspergillus or other fungi, occurs with some malignancies and connective tissue diseases
● Prolonged (months) febrile illness with cough, weight loss, generalized fatigue, drenching night sweats and peripheral eosinophilia
● Associated with chronic asthma, usually in setting of allergic bronchopulmonary aspergillosis
● Xray: patchy infiltrates in peripheral lungs with central sparing

Treatment
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● Steroids cause complete resolution

Gross description
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● Consolidation, mucus plugs in distal bronchi or bronchioles

Micro description
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● Patchy intraalveolar edema, interstitial inflammation with giant cells and eosinophils with scattered histiocytes and plasma cells
● Mucus plugs composed of inflammatory cells and cellular debris
● Charcot-Leyden crystals may be present
● Often bronchiolitis obliterans
● Blood vessel infiltration by inflammatory cells is common, but no vascular necrosis
● No diffuse alveolar damage

Differential diagnosis
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● DIP (if extensive intraalveolar macrophages)
● Langerhans cell histiocytosis (interstitial infiltrate, Langerhans cells)
● Extrinsic allergic alveolitis (less edema, more interstitial inflammation)
● Parasites
● Fungal allergies
● Other causes of pulmonary eosinophilia must be excluded

Additional References
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● Orphanet J Rare Dis 2006;1:11

End of Lung-nontumor > Other interstitial pneumonitis / fibrosis > Chronic eosinophilic pneumonia

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