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