Lung - nontumor
Other interstitial pneumonitis / fibrosis
Chronic eosinophilic pneumonia

Author: Elliot Weisenberg, M.D. (see Authors page)

Revised: 28 February 2017, last major update September 2011

Copyright: (c) 2003-2017, PathologyOutlines.com, Inc.

PubMed search: chronic eosinophilic pneumonia [title]

Cite this page: Chronic eosinophilic pneumonia. PathologyOutlines.com website. http://pathologyoutlines.com/topic/lungnontumorCEP.html. Accessed May 25th, 2017.
Definition / general
  • Reaction to drugs, Aspergillus or other fungi, occurs with some malignancies and connective tissue diseases
  • Prolonged (months) febrile illness with cough, weight loss, generalized fatigue, drenching night sweats and peripheral eosinophilia
  • Associated with chronic asthma, usually in setting of allergic bronchopulmonary aspergillosis
  • Xray: patchy infiltrates in peripheral lungs with central sparing
Treatment
  • Steroids cause complete resolution
Gross description
  • Consolidation, mucus plugs in distal bronchi or bronchioles
Microscopic (histologic) description
  • Patchy intraalveolar edema, interstitial inflammation with giant cells and eosinophils with scattered histiocytes and plasma cells
  • Mucus plugs composed of inflammatory cells and cellular debris
  • Charcot-Leyden crystals may be present
  • Often bronchiolitis obliterans
  • Blood vessel infiltration by inflammatory cells is common, but no vascular necrosis
  • No diffuse alveolar damage
Differential diagnosis
  • DIP (if extensive intra-alveolar macrophages)
  • Langerhans cell histiocytosis (interstitial infiltrate, Langerhans cells)
  • Extrinsic allergic alveolitis (less edema, more interstitial inflammation)
  • Parasites
  • Fungal allergies
  • Other causes of pulmonary eosinophilia must be excluded
Additional references