Presentation
Presented with a 1-month history of coughing, respiratory distress, and weight loss.
Patient Data
There is a severe bronchial pattern throughout the lungs. Soft tissue dense material fills multiple airways. The bronchi closer to the hilus have a "doughnut" appearance, and more distally fluid filled bronchi appear nodular. A thin pleural fissure line seen crossing the thorax on the right lateral view. Within the viewable abdomen there is decreased serosal detail which is likely related to the thin body condition of the patient.
Impression
Bronchitis most likely most likely immune mediated in origin (eosinophilic bronchopneumopathy) however infectious inflammatory airway disease is also possible.
Case Discussion
On bronchoscopic examination, there was mucus diffusely distributed in the airways. The bronchial lavage and cytology showed marked, mixed inflammation which was primarily eosinophilic.
Alternative terms for eosinophilic bronchopneumopathy are pulmonary infiltrates with eosinophils and pulmonary eosinophilia 1. This disorder produces a marked bronchial pattern with eosinophils found in pulmonary secretions and often also in peripheral blood.
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