acute eosinophilic pneumonia
Acute eosinophilic pneumonia is a type of eosinophilic lung disease diagnosed when the following combination of clinical and radiographic findings occur :
- febrile illness of less than five days' duration
- hypoxemia
- diffuse alveolar or mixed alveolar-interstitial opacities on chest radiography
- bronchoalveolar lavage (BAL) fluid consisting of >25% eosinophils
- absence of parasitic, fungal, or other infection
- prompt and complete response to corticosteroids
- no relapse after discontinuation of corticosteroids
Pathology
Most cases are idiopathic, however, a link to new or binge smoking in a subset of patients has been suggested . Peripheral blood eosinophil counts are usually normal, although they can become elevated during the subsequent clinical course. A very high eosinophil count in bronchoalveolar lavage is characteristic of the condition.
Radiographic features
Imaging features should be interpreted in the correct clinical context.
CT
Described features include :
- bilateral ground-glass areas: common
- interlobular septal thickening: common
- pleural effusions: can be present in ~80% (range 60-100%) of cases
- thickening of bronchovascular bundles: present in around two-thirds of cases
- air-space consolidation: present in around half of the cases
- ill-defined centrilobular nodules: present in around one-third of cases
Zonal distribution:
- central-to-peripheral zonal distribution
- random ~60%
- peripheral ~30%
- central ~10%
- apicobasal overall zonal distribution
- random ~65%
- lower lobes ~30%
- upper lobes ~15%
Siehe auch:
- Pleuraerguss
- Milchglasverschattungen
- verdickte interlobuläre Septen
- zentrilobuläre Lungennoduli
- pulmonale Eosinophilie
und weiter:
Assoziationen und Differentialdiagnosen zu acute eosinophilic pneumonia (AEP):
