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Tracheobronchial lesions in eosinophilic pneumonia.
[allergic bronchopulmonary aspergillosis]
Eosinophilic
pneumonia
(
EP
)
is
characterized
by
eosinophil
infiltration
in
the
lung
parenchyma
.
However
,
tracheobronchial
lesions
associated
with
the
disease
have
been
poorly
described
.
To
clarify
the
frequency
and
characteristics
of
cases
with
tracheobronchial
lesions
in
EP
,
we
performed
a
retrospective
review
of
EP
patients
.
We
included
36
EP
cases
seen
from
January
2004
to
December
2007
at
the
Kinki-
Chuo
Chest
Medical
Center
.
The
incidence
of
tracheobronchial
nodules
and
associated
clinical
features
were
analyzed
.
Of
these
36
patients
,
29
had
chronic
eosinophilic
pneumonia
(
CEP
)
;
1
,
acute
EP
;
3
,
drug-induced
EP
;
2
,
allergic
bronchopulmonary
aspergillosis
;
and
1
,
parasite-related
EP
.
Only
2
of
the
29
CEP
cases
had
tracheobronchial
lesions
.
For
both
of
these
cases
,
bronchoscopy
revealed
multiple
whitish
nodules
on
the
tracheobronchial
mucosa
.
The
associated
histopathological
findings
revealed
squamous
metaplasia
and
eosinophil
infiltration
in
the
subepithelial
region
.
In
both
cases
,
the
nodules
disappeared
after
steroid
therapy
.
The
prevalence
of
tracheobronchial
lesions
was
6
.
9
%
in
CEP
patients
and
5
.
6
%
in
EP
patients
overall
.
EP
patients
were
divided
into
3
groups
:
CEP
with
nodules
(
n
=
2
)
,
CEP
without
nodules
(
n
=
27
)
,
and
other
EP
(
n
=
7
)
.
We
found
that
the
CEP
with
nodules
group
showed
a
relatively
higher
incidence
of
respiratory
symptoms
,
higher
white
blood
cell
(
WBC
)
count
,
and
higher
levels
of
peripheral
and
bronchoalveolar
eosinophilia
than
the
other
groups
.
Tracheobronchial
nodules
represent
rare
observations
within
the
EP
population
,
which
are
likely
to
reflect
a
severe
disease
condition
.
Diseases
Validation
Diseases presenting
"multiple whitish nodules on the tracheobronchial mucosa"
symptom
allergic bronchopulmonary aspergillosis
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