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An unusual case of eosinophilic lung disease with multiple cyst formation

We report here an unusual case of eosinophilic necrotizing inflammation of the lung that mimicked chronic eosinophilic pneumonia. A 71-year-old man who lived in an unsanitary environment and was referred to our hospital with suspected pneumonia. Peripheral blood eosinophilia was observed, and comput...

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Autores principales: Nogawa, Hitomi, Suzuki, Hiroki, Kawabata, Yoshinori, Ota, Takahito, Yuki, Yoshihiko, Katagiri, Yuji, Hino, Toshihiko, Yanagawa, Naoki, Ueki, Shigeharu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7695879/
https://www.ncbi.nlm.nih.gov/pubmed/33294360
http://dx.doi.org/10.1016/j.rmcr.2020.101300
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author Nogawa, Hitomi
Suzuki, Hiroki
Kawabata, Yoshinori
Ota, Takahito
Yuki, Yoshihiko
Katagiri, Yuji
Hino, Toshihiko
Yanagawa, Naoki
Ueki, Shigeharu
author_facet Nogawa, Hitomi
Suzuki, Hiroki
Kawabata, Yoshinori
Ota, Takahito
Yuki, Yoshihiko
Katagiri, Yuji
Hino, Toshihiko
Yanagawa, Naoki
Ueki, Shigeharu
author_sort Nogawa, Hitomi
collection PubMed
description We report here an unusual case of eosinophilic necrotizing inflammation of the lung that mimicked chronic eosinophilic pneumonia. A 71-year-old man who lived in an unsanitary environment and was referred to our hospital with suspected pneumonia. Peripheral blood eosinophilia was observed, and computed tomography indicated extensive consolidation with multiple cystic lesions, mainly in the left lung. A histological analysis using video-assisted thoracic surgery revealed diffuse infiltration of inflammatory cells into the alveolar wall and massive accumulation of macrophages and eosinophils in the airspace. Many tiny eosinophilic abscesses were scattered through the tissue. These findings were more severe than those associated with chronic eosinophilic pneumonia. Immunostaining revealed the deposition of eosinophil granular protein and the presence of extracellular traps and Charcot–Leyden crystals, which suggested excessive eosinophil activation. Interestingly, the patient's symptoms and clinical findings gradually improved without treatment after admission. He was discharged to a clean residence and did not have a recurrence for 19 months. The observations suggest a hypersensitivity reaction to an environmental allergen and consequent multiple cyst formation in association with eosinophilic necrotizing inflammation, although further studies are warranted.
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spelling pubmed-76958792020-12-07 An unusual case of eosinophilic lung disease with multiple cyst formation Nogawa, Hitomi Suzuki, Hiroki Kawabata, Yoshinori Ota, Takahito Yuki, Yoshihiko Katagiri, Yuji Hino, Toshihiko Yanagawa, Naoki Ueki, Shigeharu Respir Med Case Rep Case Report We report here an unusual case of eosinophilic necrotizing inflammation of the lung that mimicked chronic eosinophilic pneumonia. A 71-year-old man who lived in an unsanitary environment and was referred to our hospital with suspected pneumonia. Peripheral blood eosinophilia was observed, and computed tomography indicated extensive consolidation with multiple cystic lesions, mainly in the left lung. A histological analysis using video-assisted thoracic surgery revealed diffuse infiltration of inflammatory cells into the alveolar wall and massive accumulation of macrophages and eosinophils in the airspace. Many tiny eosinophilic abscesses were scattered through the tissue. These findings were more severe than those associated with chronic eosinophilic pneumonia. Immunostaining revealed the deposition of eosinophil granular protein and the presence of extracellular traps and Charcot–Leyden crystals, which suggested excessive eosinophil activation. Interestingly, the patient's symptoms and clinical findings gradually improved without treatment after admission. He was discharged to a clean residence and did not have a recurrence for 19 months. The observations suggest a hypersensitivity reaction to an environmental allergen and consequent multiple cyst formation in association with eosinophilic necrotizing inflammation, although further studies are warranted. Elsevier 2020-11-19 /pmc/articles/PMC7695879/ /pubmed/33294360 http://dx.doi.org/10.1016/j.rmcr.2020.101300 Text en © 2020 The Authors http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Nogawa, Hitomi
Suzuki, Hiroki
Kawabata, Yoshinori
Ota, Takahito
Yuki, Yoshihiko
Katagiri, Yuji
Hino, Toshihiko
Yanagawa, Naoki
Ueki, Shigeharu
An unusual case of eosinophilic lung disease with multiple cyst formation
title An unusual case of eosinophilic lung disease with multiple cyst formation
title_full An unusual case of eosinophilic lung disease with multiple cyst formation
title_fullStr An unusual case of eosinophilic lung disease with multiple cyst formation
title_full_unstemmed An unusual case of eosinophilic lung disease with multiple cyst formation
title_short An unusual case of eosinophilic lung disease with multiple cyst formation
title_sort unusual case of eosinophilic lung disease with multiple cyst formation
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7695879/
https://www.ncbi.nlm.nih.gov/pubmed/33294360
http://dx.doi.org/10.1016/j.rmcr.2020.101300
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