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
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Diseases presenting "lung parenchyma" symptom

allergic bronchopulmonary aspergillosis

dracunculiasis

liposarcoma

lymphangioleiomyomatosis

well-differentiated liposarcoma

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