The Common Vein

• 60 y.o. female with a history of GERD, and HTN and
• admission 3 years prior
  • for chronic cough,
  • fevers,
  • dyspnea, and
  • fatigue
    • biopsy proven
    • subacute and
    • chronic
    • organizing  eosinophilic PNA
    • progressive phase of subacute to chronic eosinophilic pneumonia, including
      • interstitial fibrosis,
      • intraalveolar fibrin deposits with
      • eosinophils and
      • lymphohistiocytoses and
      • fibroblastic proliferation foci.
    • ORGANIZING PNEUMONIA SHOWING SUBACUTE AND CHRONIC PHASES, FIBRINOUS AIRSPACE EXODUATES WITH ADMIXED EOSINOPHILS AND HISTIOCYTES.
      THE DISTRIBUTION IS MULTIFOCAL AND PATCHY.
      NO EVIDENCE OF VASCULITIS OR GRANULOMA SEEN.
  • started on prednisone
  • started on mepolizumab  1 year later and
  • weaned off prednisone 2 years ago
  • with improvement of symptoms and
  • CXR now presenting for a follow up.

1 year Prior to Illness

 

Presents with Cough and Dyspnea
Bibasilar Infiltrates and Multifocal Nodular Infiltrates

 

2 Weeks Later

Bronchiolectasis

3 Months After Presentation

7 Months After Presentation Improving Bibasilar Infiltrates

8 Months After Presentation

9 Months After Presentation

Links and References

TCV Case 703