Churg-Strauss syndrome - High resolution CT and pathologic findings

Objectives: the purpose of this study was to evaluate high-resolution CT findings in 7 patients with Churg-Strauss syndrome and to compare the CT with the histopathologic findings.Materials and Methods: High-resolution CT scans of 7 asthmatic patients (4 women, 3 men, age range, 34-62 years, mean 49 years) with Churg-Strauss syndrome were reviewed by 2 observers. Histologic specimens of lung obtained at surgical (n = 3) or transbronchial (n = 3) biopsy or autopsy (n = 1) were reviewed by an expert lung pathologist. the diagnosis of Churg-Strauss was based on clinical, laboratory, and histologic findings.Results: Parenchymal and airway abnormalities included ground-glass opacities (n = 5), areas of air-space consolidation (n = 4), centrilobular nodules (n = 5), nodules 1-3 cm in diameter (n = 3), interlobular septal thickening (n = 4), bronchial wall thickening in = 4), and areas of atelectasis (n = 1). Surgical biopsy (n = 3) and autopsy (n = 1) specimens demonstrated airspace disease in 3 patients, interlobular septal thickening in 3 patients, and airway abnormalities in 2 patients. Histologically, the airspace disease included eosinophilic pneumonia (n = 2) and small foci of organizing pneumonia (n = 1). the septal thickening was due to edema combined with numerous (n = 2) or few (n = 1) eosinophils. the airway abnormalities (n = 2) included muscle hypertrophy and large airway wall necrosis (n = 1) and eosinophilic infiltration of the airway walls (n = 1). Transbronchial biopsy (n = 3) demonstrated increased eosinophils.Conclusion: the main high-resolution CT findings of Churg Strauss syndrome consist of airspace consolidation or ground-glass opacities, septal lines, and bronchial wall thickening. These reflect the presence of eosinophilic infiltration of the airspaces, interstitium, and airways, and interstitial edema.Vancouver Gen Hosp, Dept Radiol, Vancouver, BC V5Z 1M9, CanadaUniversidade Federal de São Paulo, Dept Diagnost Imaging, São Paulo, BrazilKurume Univ, Sch Med, Kurume, Fukuoka 830, JapanOsaka Univ, Sch Med, Dept Radiol, Suita, Osaka, JapanUniv British Columbia, Dept Pathol, Vancouver, BC, CanadaUniversidade Federal de São Paulo, Dept Diagnost Imaging, São Paulo, BrazilWeb of Scienc