CHRONIC EOSINOPHILIC PNEUMONIA AND SARCOIDOSIS: AN UNUSUAL ASSOCIATION

TYPE: Abstract Publication TOPIC: Diffuse Lung Disease PURPOSE: Chronic Eosinophilic Pneumonia (EP) is a rare condition which associated with Sarcoidosis is extremely unusual. We report a case of these concomitant diseases. METHODS: A 71-year-old male former smoker (20 pack years) with no significant past medical history presented to a hospital with cough, sputum and involuntary weight loss. He has performed a chest radiography in primary care which showed a right lower pulmonary nodule. Computed Tomography (CT) scan revealed a 63 mm heterogeneous mass with necrotic area on posterior segment of right lower lobe (RLL) and a few thoracic and abdominal adenopathies (subcarinal, paraesophageal, bilateral hilar, paratracheal, retrocaval and prevascular). Bronchofibroscopy, bronchial biopsy, wash and brushing shows a nonspecific inflammation. Following positron emission tomography scan showed a mass in RLL and multiple adenopathies with intense uptake (SUV 5.7, SUV 7.2, respectively). He also performed transthoracic biopsy CT-guided, which revealed an EP with peripheral blood eosinophilia. The biopsy of subcarinal adenopathy by endobronchial ultrasound revealed non-necrotizing granulomas. Due to inconclusive results, he repeated the transthoracic biopsy which corroborated the diagnosis of EP. However, EP rarely has lymph node involvement, reason why a multidisciplinary team opted by mediastinoscopy to exclude neoplastic disease. The surgical biopsy of anterior mediastinal and cervical adenopathy was compatible with Sarcoidosis. RESULTS: The patient started systemic glucocorticoid with disease stability, although significant imaging worsening (1-year follow-up TC) was developed after dose tapering. CONCLUSIONS: EP accompanied by Sarcoidosis with lymph node involvement can mimicneoplastic disease. CLINICAL IMPLICATIONS: Prominent mediastinal adenopathies in EP is rare. EP can be associated to other conditions. DISCLOSURE: No significant relationships. KEYWORDS: Chronic Eosinophilic Pneumonia, sarcoidosis