Chronic eosinophilic pneumonia: CT findings in six cases

Abstract

We reviewed the chest radiographs and CT scans in six patients with proved chronic eosinophilic pneumonia. In all patients, the chest radiographs showed patchy air-space consolidation, and in five of six cases, the consolidation was most marked in the middle and upper lung zones. In only one patient was the classic pattern of air-space consolidation that is confined to the outer third of the lungs readily apparent. In three patients, the consolidation appeared to be diffuse, although a slight peripheral predominance was present. In two patients, a peripheral predominance was difficult to appreciate, even in retrospect. The CT scans in all cases showed peripheral air-space consolidation. In addition, mediastinal adenopathy was identified on CT scans in three cases. This has not been described before in association with chronic eosinophilic pneumonia. A follow-up CT scan in one patient showed resolution of the adenopathy and marked improvement in the peripheral air-space disease within 2 weeks. We conclude that patients with chronic eosinophilic pneumonia show predominantly peripheral air-space consolidation on CT scans, even when this distribution is not readily apparent on the radiograph. CT may be helpful in the diagnosis when the clinical findings are suggestive, but the radiographic pattern is nonspecific.

Case Report Muscle pain, fever, cough, and progressive dyspnea in a woman with eosinophilic pneumonia

“…The CT findings in AEP patients consisted mainly of bilateral patchy areas of ground-glass attenuation, interlobular septal thickening, thickening of the bronchovascular bundles, and the presence of pleural effusion without cardiomegaly (Cheon et al, 1996). Unlike AEP, bilateral air-space consolidation with peripheral predominance was the most frequent CT finding in CEP, followed by linear and reticular opacities and ground-glass opacities (Mayo et al, 1989;Arakawa et al, 2001). HRCT manifestations of drug-induced EPs resemble those of chronic EP, bilateral air-space consolidation, peripherally distributed ground-glass opacities, nodules, and irregular lines (Souza et al, 2006).…”

Idiopathic Chronic Eosinophilic Pneumonia: Retrospective Analysis Of 17 Cases From Single Center In Turkey

“…Thoracic CT reveals opacities, mostly bilateral with upper lobe predominance (10)(11)(12). Peripheral symmetrical alveolar lesions, defined as the "photographic negative" of pulmonary edema, occur in 25% of the patients, and they are diagnostic of ICEP (13,14).…”

Manifestation peculiarities of idiopathic chronic eosinophilic pneumonia

“…There was no pleurisy case in our ICEP group. Chronic eosinophilic pneumonia may be present with pleural effusion [39], but it is not a characteristic sign [37,38,40]. However, parapneumonic effusion is common for infectious pneumonia [26,33,41].…”