title: Eosinophilic granuloma of the skeleton with involvement of the lung: a report of three cases.
abstract: Three adult patients with chronic bilateral pulmonary infiltrates due to eosinophilic granuloma are described. The diagnosis was based on histologically proven antecedent or concomitant osseous eosinophilic granuloma in all cases. Electron microscopy was performed in two cases, showing abundant Lx-bodies in both. Pulmonary tissue was obtained in the same two cases, yielding eosinophilic granulomas in one and non-specific septal infiltrates in the other. In the third case the assumption of pulmonary eosinophilic granuloma was made by clinical analogy, thus, avoiding lung biopsy. The course was characterized by lasting benefit from skeletal surgery in all patients and by refractoriness of pulmonary lesions to immunodepressants given to two patients. Progression of pulmonary disease was minimal or none during the observation period of four, three, and three years, respectively. Diffuse pulmonary infiltrates may be a manifestation of a covert osseous eosinophilic granuloma. Skeletal screening by x-ray or scintigraphy should be part of the work-up of otherwise unexplained diffuse lung lesions. It may obviate the need for lung biopsy.
mesh_terms: D000328:Adult; D001706:Biopsy; D001842:Bone and Bones / Q000473:pathology; D004803:Eosinophilic Granuloma / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008168:Lung / Q000473:pathology; D008171:Lung Diseases / Q000175:diagnosis*; D008297:Male; D008854:Microscopy, Electron; D008875:Middle Aged