Images courtesy of Dr. Harry Shulman (Sunnybrook and Women's College, Toronto, Ontario)

Eosinophilic Lung Disease

A group of diseases usually associated with peripheral eosinophilia and pulmonary infiltrates.

Associations: Eosinophilic pneumonia is the most widely known entity, but vasculitides, various parasitic  infections, drug reactions, and rarely lymphoproliferative eosinophilic syndromes (eg hypereosinophilic syndrome) may be responsible.

Clinical Pattern: Once the diagnosis is established and infections, particularly tuberculosis, are clinically excluded, the patients usually have a rapid response to steroid therapy. This is typical and almost diagnostic of eosinophilic pneumonia.

Classic CXR: A peripheral airspace pattern often with a fleeting or evanescent fluctuation in severity. Typically NOT associated with visible adenopathy or significant pleural effusions.

"Aunt Sophies":

Lung disease that has a peripheral pattern:
            Cryptogenic organizing pneumonia
            Atypical pulmonary edema
            Infective pneumonia
            Multiple peripheral pulmonary emboli