title: Pathological and high resolution CT findings in Churg-Strauss syndrome.
abstract: OBJECTIVE
  To investigate the Churg-Strauss syndrome (CSS) associated lung involvement, concentrating on clinical characteristics, pathological findings of lung involvements, response to treatment, and prognosis.
  
  
  METHODS
  We retrospectively analyzed the characters of the clinical manifestations, thin-section CT and pathological findings of CSS. The study involved 16 patients. Clinical data were obtained by chart review. All patients underwent transbronchial lung biopsy (TBLB). Six of them underwent surgical lung biopsy as well.
  
  
  RESULTS
  The patients included 7 men and 9 women, aged from 14 to 61 years (median, 47.5 years). Extrathoracic organs involved included nervous system (7/16) and skin (5/16). Respiratory symptoms included cough (12/16), exertional dyspnea (11/16), hemoptysis (4/16), and chest pain (3/16). CT findings included bilateral ground-glass opacities (12/16), bilateral patchy opacities (12/16), and centrilobular nodules (6/16). The pathological findings of TBLB demonstrated increased eosinophils (3/16), vasculitis (3/16), and interstitial pneumonia (16/16). The pathological findings of surgical lung biopsy of 6 cases showed necrotizing vasculitis in 4 cases, capillaries in 5, eosinophilic pneumonia in 3, granulomas in 2, and airway abnormalities in 3. All patients improved in symptoms after therapy during the study period (range, 3 to 51 months; median, 15 months).
  
  
  CONCLUSIONS
  Asthma may be present in CSS patient when there is bronchial involvement. Ground-glass opacities and consolidation seen on high-resolution CT reflect the presence of eosinophilic pneumonia, vasculitis, and pulmonary alveolar hemorrhage. TBLB has significant limitations for the diagnosis of CSS. Early diagnosis and therapy can result in satisfactory prognosis.
authors.affiliation: Department of Pathology, Peking Union Medical College, Beijing 100730, China.
authors.forename: Rui-e
authors.initials: RE
authors.lastname: Feng
authors.forename: Wen-bing
authors.initials: WB
authors.lastname: Xu
authors.forename: Ju-hong
authors.initials: JH
authors.lastname: Shi
authors.forename: Artin
authors.initials: A
authors.lastname: Mahmoudi
authors.forename: Wen-bing
authors.initials: WB
authors.lastname: Mu
authors.forename: Wen-jie
authors.initials: WJ
authors.lastname: Zheng
authors.forename: Yuan-jue
authors.initials: YJ
authors.lastname: Zhu
authors.forename: Hong-rui
authors.initials: HR
authors.lastname: Liu
mesh_terms: D000293:Adolescent; D000328:Adult; D001249:Asthma / Q000503:physiopathology; D001706:Biopsy; D015267:Churg-Strauss Syndrome / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000473:pathology*; D003520:Cyclophosphamide; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008168:Lung / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D007166:Immunosuppressive Agents; D003520:Cyclophosphamide