Granulomatous Lung Masses in an Elderly Patient with Inactive Crohn's Disease

Lucero, Pedro F.; Frey, William C.; Shaffer, Richard T.; Morris, Michael J.

doi:10.1097/00054725-200108000-00012

Cited by 18 publications

(13 citation statements)

References 17 publications

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“…Other investigators have noted a reduction in pulmonary transfer factor for carbon monoxide in patients with CD [10,11]. There appears to be some evidence to suggest that abnormalities in pulmonary function may mirror the activity of CD, however, granulomatous inflammation in the lung has also been reported in CD patients after a period free from gastrointestinal symptoms [12]. Differences between CD patients and control patients have also been demonstrated by studies looking at induced sputum analysis [13,14].…”

Section: Discussionmentioning

confidence: 94%

Pneumothorax as a presenting feature of granulomatous disease of the lung in a patient with Crohnʼs disease

Smith

Crampton²,

Pritchard³

et al. 2009

European Journal of Gastroenterology & Hepatology

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Pulmonary disease and abnormalities of pulmonary function testing have been described in patients with Crohn's disease. The case of a 25-year-old female presenting with pneumothorax as a complication of Crohn's-related granulomatous lung disease is described here. The patient presented with symptoms of dyspnoea and chest pain, a chest radiograph revealed a pneumothorax on the right side. This pneumothorax did not resolve with intercostal tube drainage. Video-assisted thoracoscopy was performed at which small blebs were observed on the surface of the lung. Histology from a resected specimen of lung tissue demonstrated noncaseating granulomas. Colonoscopy was performed to investigate synchronous iron deficiency anaemia. This showed changes typical of Crohn's colitis. Granulomas were identified on histological examination of colonic tissue. Although pulmonary involvement in Crohn's disease has become increasingly recognised, pneumothorax has not been described previously.

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Section: Discussionmentioning

confidence: 94%

Pneumothorax as a presenting feature of granulomatous disease of the lung in a patient with Crohnʼs disease

Smith

Crampton²,

Pritchard³

et al. 2009

European Journal of Gastroenterology & Hepatology

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“…Respiratory disease associated with IBD in adults includes interstitial pneumonitis, tracheal stenosis, bronchiolitis, pulmonary vasculitis, bronchiolitis obliterans with organizing pneumonia, necrotic pulmonary nodules, serositis involving intrathoracic structures in the form of pleural effusions or pericarditis, and pulmonary infiltrates with eosinophilia. [2][3][4][5][6][7] Pediatric reports remain sketchy [8][9][10][11] and include isolated or diffuse lung granulomas. Pulmonary infiltrates in the setting of immunosuppression present a diagnostic dilemma, and definitive diagnosis often requires a lung biopsy.…”

Section: Discussionmentioning

confidence: 99%

Lung Lesions in Children With Crohn's Disease Presenting as Nonresolving Pneumonias and Response to Infliximab Therapy

et al. 2006

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Lung lesions in children with Crohn's disease are often difficult to diagnose and treat. We report here 3 children (aged 13, 14, and 17 years) on immunosuppressive therapy for previously diagnosed Crohn's disease who presented with nonresolving pneumonias. All 3 had unfavorable response to empiric antibiotics and had progression of lesions. Cultures of sputum and blood did not yield any organisms. Subsequent lung biopsies revealed noncaseating granulomas with giant cells in 2 subjects and bronchiolitis obliterans with organizing pneumonia in the third. All patients were treated with infliximab, a novel anti-tumor necrosis factor monoclonal antibody, and showed rapid clinical and radiologic response. We emphasize that a high index of suspicion for noninfectious etiologies needs to be maintained in patients with Crohn's disease who present with lung lesions to ensure timely intervention. Infliximab therapy seems to be effective and well tolerated in such patients.

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“…8 The appearance of multiple lung masses in Crohn's disease has been described but is very uncommon. 9 Other infections to consider besides the more common infectious agents are Nocardia, Aspergillus fumigatus, other fungi (Coccidiomycosis, Cryptococcosis and Histoplasmosis), and measles, but cultures and serological examinations for these were negative.…”

Section: Discussionmentioning

confidence: 99%

Mycobacterium xenopi infection in an immunosuppressed patient with Crohn's disease

Majoor

Schreurs

Weers-Pothoff

2004

Thorax

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A 48 year old patient with active Crohn's disease presented with bilateral nodules over his lungs resembling malignant metastasis. Bronchoscopic and pathological examination of the airways and sputum did not show any malignancy. After 6 weeks Mycobacterium xenopi was cultured from his bronchial washings while all other cultures remained negative. Treatment was started with rifampicin, ethambutol, and clarithromycin and, after 9 months of treatment, there was an almost complete resolution of his chest radiograph.

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Granulomatous Lung Masses in an Elderly Patient with Inactive Crohn's Disease

Cited by 18 publications

References 17 publications

Pneumothorax as a presenting feature of granulomatous disease of the lung in a patient with Crohnʼs disease

Pneumothorax as a presenting feature of granulomatous disease of the lung in a patient with Crohnʼs disease

Lung Lesions in Children With Crohn's Disease Presenting as Nonresolving Pneumonias and Response to Infliximab Therapy

Mycobacterium xenopi infection in an immunosuppressed patient with Crohn's disease

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