Interstitial pneumonia

Interstitial Pneumonia

Churg-Strauss syndrome

At low power, small granulomatous foci appear around small- to medium-sized arteries and veins. The multinucleated giant cells are indicated by the dark spots (arrow).

Here, one of the granulomatous foci shows fibrosis and chronic inflammatory cells including a number of eosinophils. The arrow indicates a multinucleated giant cell. The asterisk is in the center of a zone of necrosis--a so-called eosinophilic abscess.

A medium-sized pulmonary artery has a destructive angiitis. The inflammatory cells in the intima, media, and surrounding tissue are mainly eosinophils. The arrows mark the media of the vessel.

Summary of findings in Churg-Strauss syndrome

Granulomas or granulomatosis with eosinophils, eosinophilic abscesses
Necrotizing angiitis
Eosinophilic pneumonia
Features of asthma

Eosinophilic pneumonia

Consolidation of lung parenchyma with mild alveolar wall thickening is part of Churg-Strauss syndrome, but similar changes occur in eosinophilic pneumonia of any type and in allergic bronchopulmonary aspergillosis.

Note that the alveoli are filled with a mixture of macrophages and eosinophils. Alveolar walls are variably inflamed.

Contents

						At low power, small granulomatous foci appear around small- to medium-sized arteries and veins. The multinucleated giant cells are indicated by the dark spots (arrow).
						Here, one of the granulomatous foci shows fibrosis and chronic inflammatory cells including a number of eosinophils. The arrow indicates a multinucleated giant cell. The asterisk is in the center of a zone of necrosis--a so-called eosinophilic abscess.
						A medium-sized pulmonary artery has a destructive angiitis. The inflammatory cells in the intima, media, and surrounding tissue are mainly eosinophils. The arrows mark the media of the vessel.