Lung - nontumor - Allergic granulomatosis and angiitis

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Lung-nontumor

Granulomatous inflammation (non-infectious)

Allergic granulomatosis and angiitis

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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● Also called Churg-Strauss syndrome
● Very rare
● Systemic vasculitis resembling polyarteritis nodosa or microscopic polyangiitis; associated with asthma, peripheral eosinophilia, pulmonary involvement and fever
● Rarely presents without pulmonary disease as fever of unknown origin
● < 50% have positive ANCA, often anti-myeloperoxidase

Treatment
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● Steroids: effective, but patients may relapse

Micro description
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● Lung and extrapulmonary sites (skin, heart, nervous system, GI) have prominent eosinophilic infiltrate, granulomatous reaction around necrotic foci with radially arranged histiocytes and pallisading giant cells near small arteries or arterioles, eosinophilic vasculitis
● May have fibrin-rich edema, lymphocytes, sarcoid-like granulomas, focal fibrosis and eosinophilic microabscesses

Differential Diagnosis
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● Wegener granulomatosis:: kidney involvement, no asthma, no tissue or serum eosinophilia
● Rheumatoid nodules: no tissue or serum eosinophilia, no asthma

End of Lung-nontumor > Granulomatous inflammation (non-infectious) > Allergic granulomatosis and angiitis

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