case_images: PMC11769722_01
case_images: High-resolution CT scan images showing various stages of pulmonary changes. (A) Bronchiectasis with intraluminal high-attenuation mucus in the right upper lobe, associated with peripheral lung atelectasis and a tree-in-bud appearance, along with a solid nodule in the lingual segment of the left upper lobe. (B) Partial absorption of bilateral upper lung lesions after 8 months of anti-tuberculosis therapy, with a reduction in the size of the lesions. (C) A newly developed solid mass in the lingual segment of the left upper lobe, observed 4 months post-surgery, indicating possible post-surgical changes or recurrence. (D) Marked reduction in the size of the solid mass in the left upper lobe lingual segment after six weeks of steroid treatment, suggesting a significant therapeutic response.
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case_images: Additionally, a solid nodule was noted in the lingual segment of the left upper lobe (Figure 1A). Follow-up radiological assessments demonstrated gradual partial absorption of bilateral upper lung lesions (Figure 1B). Four months post-surgery, the follow-up chest CT scans revealed a newly solid mass in the lingual segment of the left upper lobe (Figure 1C). CT scan revealed obvious absorption of the lesion (Figure 1D), along with gradual reductions in serum total IgE and EOS levels. Currently, the patient continues on a maintenance dose of prednisone 5 mg qd, with regular outpatient visits and plans for gradual medication discontinuation.
case_images: Histopathological examination of the resection specimen showing chronic inflammation. (A) Marked infiltration of eosinophils, accumulation of mononuclear macrophages, and a multinucleated giant cell reaction, highlighting the inflammatory response (Hematoxylin and Eosin stain, x200). (B) Significant necrotic material and eosinophil accumulation within some bronchial lumens, with the presence of Charcot-Leyden crystals (highlighted by the red arrow), indicating an ongoing inflammatory process (Hematoxylin and Eosin stain, x400).
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case_images: Histopathological examination of the excised lung tissue from both lobes revealed chronic inflammation with widespread hemorrhage and deposition of erythematous exudate within certain alveolar regions, accompanied by focal accumulation of eosinophils, aggregated mononuclear macrophages, and scattered multinucleated giant cell reactions in localized areas (Figure 2A). Significant necrotic material and eosinophil accumulation, along with Charcot-Leyden crystal formation, were observed in some bronchial lumens (Figure 2B).