ObjectiveTo summarize the clinical manifestations, diagnosis and treatments of chronic eosinophilic pneumonia (CEP).MethodsThe clinical and pathological data of five patients with CEP diagnosed in this hospital between January 2011 and January 2015 were retrospectively analyzed.ResultsThere were five CEP cases including two males and three females, and one case with allergic rhinitis, two cases with bronchial asthma, two cases with allergic history, and one case with allergic skin rash. The main clinical manifestations were fever, cough, expectoration, shortness of breath and chest pain, and often accompanied by fatigue, anorexia and weight loss. The main signs included moist rales, scattered wheeze and crackles. There were significantly increased peripheral blood eosinophils count, the proportion of eosinophils, and the proportion of eosinophils in bronchoalveolar lavage fluid in all five cases. The main imaging features were airway infiltration, real change shadow and ground glass shadow. All of five cases were treated with glucocorticoid, and one of them relapsed during follow-up.ConclusionsThe onset of CEP is insidious. The clinical manifestations of CEP are lack of specificity, and often associate with asthma and allergic dermatitis. Eosinophils significantly increase in peripheral blood and bronchoalveolar lavage fluid in most of CEP patients. The typical image is peripheral and subpleural distribution of lung infiltrates.
Objective To improve our recognition of ground-glass opacity (GGO) through analyzing the imaging and pathological features of patients with focal GGO lung nodule. Methods Thirty patients with focal GGO nodule were assigned into a preinvasive lesion group, a minimally invasive adenocarcinoma (MIA) group, and an invasive adenocarcinoma (IAC) group. The imaging features were retrospectively analyzed and pathological features by histological Masson staining, collagen Ⅳ staining and Vitoria blue staining were also compared among three groups. Furthermore, the relationship between pathology and imaging characteristics was studied too. Results Among 30 patients with focal GGO nodule, preinvasive lesions, MIA and IAC respectively occurred in 13, 3 and 14 cases. Size of nodules and solid portion were highest in the IAC group, middle in the MIA group, and lowest in the preinvasive lesion group. Similarly, signs of lobulation, spiculation and air bronchogram were seen mostly in the IAC group, and least in preinvasive lesion group. The spatial relationship between GGO nodules and supplying blood vessels was analyzed, and Type Ⅲ was more commonly seen in the IAC group with comparison to type Ⅱ more likely seen in the preinvasive lesion group. Moreover, collagen Ⅳ and Vitoria blue staining indicated that reticular fibers and collagenous fibers lessened around tumor tissue in the IAC group, whereas collagenous fibers proliferation and fibrous scar were shown by Masson staining in the IAC group. In CT-pathologic comparison, type Ⅲ supplying blood vessels were mostly seen in the IAC patients with obvious fibrous scar. Conclusions Persistent focal GGO nodules with larger size and higher percent of solid component are signs of malignancy. In tumor progression process, tumor cells break the reticular fibers and collagenous fibers in alveolar wall, then stimulate fibroblast hyperplasia and secrete collagenous fibers, thereby develop the central fibrous scar in tumor tissue, which might be the pathologic foundation of vascular bundle sign.