title: Pulmonary necrobiotic nodules in Crohn's disease: a rare extra-intestinal manifestation.
abstract: Pulmonary necrobiotic nodules represent a rare extra-intestinal manifestation of Crohn's disease. Histologically, they are composed of sterile aggregates of inflammatory cells with necrosis. The differential diagnosis is broad, and exclusion of infectious etiologies is mandatory before starting immunosuppressive therapy. Here, we present the fifth reported case of pulmonary necrobiotic nodules in Crohn's disease. Our patient had new-onset Crohn's disease associated with both cavitating and non-cavitating lung nodules that were confirmed to be necrobiotic nodules by biopsy. The patient was started on mesalamine and prednisone, with subsequent improvement of his gastrointestinal symptoms and regression of the necrobiotic nodules.
authors.affiliation: Department of Pulmonary, Critical Care, and Sleep Disorders Medicine kaelke01@louisville.edu.
authors.forename: Karim
authors.initials: K
authors.lastname: El-Kersh
authors.affiliation: Department of Pathology, University of Louisville, Louisville, Kentucky.
authors.forename: Mostafa
authors.initials: M
authors.lastname: Fraig
authors.affiliation: Department of Pulmonary, Critical Care, and Sleep Disorders Medicine.
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Cavallazzi
authors.affiliation: Department of Pulmonary, Critical Care, and Sleep Disorders Medicine.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Saad
authors.affiliation: Department of Pulmonary, Critical Care, and Sleep Disorders Medicine.
authors.forename: Rafael L
authors.initials: RL
authors.lastname: Perez
mesh_terms: D003424:Crohn Disease / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D008168:Lung / Q000473:pathology*; D008297:Male; D055613:Multiple Pulmonary Nodules / Q000175:diagnosis / Q000209:etiology*; D009336:Necrosis / Q000209:etiology; D055815:Young Adult
keywords: Crohn's disease; pulmonary necrobiotic nodules; video-assisted thoracoscopy