Eosinophilic lung diseases: CT imaging findings and differential diagnosis

Congress:

ECR 2020

Poster Number:

C-08460

Type:

Educational Exhibit

Keywords:

Not applicable, Haematologic diseases, Diagnostic procedure, CT, Lung, Chest

Authors:

P. Simkus¹, A. Banišauskaitė¹, J. Noreikaite², V. Buroviené¹, J. ZAVECKIENE¹, M. Arzanauskaite²; ¹Kaunas/LT, ²Liverpool/UK

DOI:

10.26044/ecr2020/C-08460

DOI-Link:

https://dx.doi.org/10.26044/ecr2020/C-08460

Fig. 1: Classification of eosinophilic lung diseases.

Fig. 2: Secondary causes of pulmonary eosinophilia.

Table 1: Clinical, laboratory and radiological findings of SPE.

Fig. 3: Allergic bronchopulmonary aspergillosis and simple pulmonary eosinophilia...

Learning objectives

To review the most common eosinophilic lung diseases. To discuss CT imaging findings and differential diagnosis of eosinophilic lung diseases.

Background

Eosinophils are multifunctional polymorphonuclear leukocytes that serve as an end-stage effector cells and also have specialized roles in the host defense mechanism. They contain several eosinophil-specific proteins in cytoplasmic granules and sometimes can harm the host by releasing specific proteins that are cytotoxic to tissues, resulting in pathologic processes. One of the proteins forms Charcot-Leiden crystals, presence of which in tissues and sputum is typical for eosinophil-related disease. Eosinophilic lung diseasesare a heterogeneous group of disorders that have association with tissue or peripheral blood eosinophilia....

Findings and procedure details

Simple pulmonary eosinophilia (Loeffler syndrome): Simple pulmonary eosinophilia (SPE) can either be idiopathic or secondary to the presence of parasites, drugs or allergic bronchopulmonary aspergillosis (ABPA) with the most common causes being drugs and ascariasis (Table 1). Diagnostic criteria of SPE are: Migrating pulmonary opacities (Fig. 3.); Increased peripheral blood eosinophils; Minimal or no respiratory symptoms; Spontaneous resolution within 1 month. Acute eosinophilic pneumonia (AEP) A unique hypersensitivity reaction to an inhaled antigen with reported association between AEP and cigarette smoking, exposure to dust or...

Conclusion

The diagnosis of eosinophilic lung diseases is often challenging. Imaging, in particular chest CT, plays an important role in differential diagnosis of eosinophilic lung diseases. Multidisciplinary approach with integration of clinical, radiologic, and pathologic findings is essential for the diagnosis and management.

Personal information and conflict of interest

P. Simkus; Kaunas/LT - nothing to disclose A. Banišauskaitė; Kaunas/LT - nothing to disclose J. Noreikaite; Liverpool/UK - nothing to disclose V. Buroviené; Kaunas/LT - nothing to disclose J. Zaveckiene; Kaunas/LT - nothing to disclose M. Arzanauskaite; Liverpool/UK - nothing to disclose

References

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