J Pathol Transl Med.  2019 Jan;53(1):66-69. 10.4132/jptm.2017.12.13.

Rare Manifestations of Churg-Strauss Syndrome with Mediastinal and Hilar Lymphadenopathies: Report of an Autopsy Case

Affiliations
  • 1Department of Pathology and Laboratory Medicine, Hartford Hospital, Hartford, CT, USA. woocheal.cho@hhchealth.org

Abstract

No abstract available.


MeSH Terms

Autopsy*
Churg-Strauss Syndrome*

Figure

  • Fig. 1. Gross and histologic findings of pulmonary nodules. (A) The right lung (570 g) grossly displays multiple peripherally located palpable nodules (dashed circles), measuring up to 1.5 cm in greatest dimension. The nodules are tan, firm, and relatively well-circumscribed with an irregular border. Also noted are significant subcarinal (not shown) and hilar (dashed rectangle) lymphadenopathies with a mild-moderate anthracotic pigment deposition. (B) Histologically, the lung nodules display prominent necrotizing granulomatous inflammation with surrounding tissues infiltrated by lymphocytes and rare scattered eosinophils. (C) Extravascular eosinophilic infiltration with associated granulomatous inflammation without forming an overt necrotizing vasculitis is also noted.

  • Fig. 2. Histologic spectrum of perivascular eosinophilic granulomatous inflammation. (A–C) A few small-sized arteries reveal a prominent necrotizing granulomatous inflammation focally involving the vessel wall (B, elastin stain). Occasionally, the center of the necrosis shows rare eosinophils with partially degenerated nuclei (arrows). (D, E) The majority of vessels involved by granulomatous inflammation do not reveal an overt necrotizing vasculitis. Viable eosinophils are more readily identified within these granulomas.

  • Fig. 3. Histologic findings of lymph nodes. (A–D) The mediastinal and hilar lymph nodes display prominent necrotizing granulomas. Within the center of the necrosis are numerous necrotic or degenerating eosinophils without intact nuclei but predominantly with acidophilic granules (A-C). In contrast, the periphery of or outside the necrotic zone show more readily identifiable eosinophilic infiltrates (D).


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