Lung windows:
Thoughts?
Wednesday, October 11, 2006
Follow up to change in mental status
This patient presented with change in MS. The CXR had shown some patchy markings but nothing specific. But the right hilar was full-looking so a CT was done:
Lung windows:
Thoughts?
Lung windows:
Thoughts?
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3 comments - CLICK HERE to read & add your own!:
Nocardia and other atypical agents would cause lung disease and CNS problems but the lp was negative
There is a fairly large infiltrate with a mass. Lung Ca with paraneoplastic syndrome?
He was bronched. Result is from Right middle lobe, transbronchial biopsy: Interstitial pneumonitis with focal eosinophils.
Now what?
Interesting, but at this point a non-specific finding. Was there any peripheral eosinophilia? Was a BAL sent for a differential? Any evidence to suggest a vasculitis?
With the mental status changes, if there are supporting data, you'd consider something like Churg-Strauss or even Wegeners here. Most other pulmonary eosinophilic syndromes (AEP, CEP) are not associated with CNS findings.
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