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This is an HRCT study showing bilateral non-segmental ground glass opacification mixed with nodular consolidations, plus a minor degree of reticulation and fibrotic bands; this predominantly involves the right lung – the main pattern of distribution is peripheral and in the upper and middle zones, with relative sparing of the central areas and bases.
These findings are highly suggestive of chronic eosinophilic pneumonia. I would correlate these findings with lab results, which should reveal elevated blood eosinophils for this diagnosis.
The main differential diagnosis in this case is cryptogenic organizing pneumonia.
I would flag this case for discussion at pulmonary MDT.
Question:
What is the usual management in this case and how can it confirm the diagnosis?
This condition is typically managed by corticosteroid therapy, and it usually exhibits a dramatic improvement in both radiological findings and symptoms – this can help confirm the diagnosis.
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