case_images: PMC11181888_01
case_images: H&E staining of biopsy specimens in Cases 1 and 3. (a) Eosinophil infiltration (red arrow) and plasma cell presence (blue arrow) beneath nasal polyp mucosa (Case 1, magnification x10). (b) Abundant eosinophilic infiltrates (red arrow) within nasal polyp tissues (Case 3, magnification x10). (c) Evidence of lymphocyte, plasma cell, and eosinophil infiltration (red arrow) in small bronchial mucosa tissues (Case 3, magnification x10).. H&E: hematoxylin and eosin.
case_images: 10.1177_2050313X241261152-fig1.jpg
case_images: PMC11181888_03_10.1177_2050313X241261152-fig1.jpg
case_images: fig1-2050313X241261152
case_images: In 2018, the patient underwent pansinusectomy at our hospital, and the pathology results revealed EOS infiltration in the resected tissues (Figure 1(b)). Bronchoscopy was then performed, and transbronchial lung biopsy from the left lower lobe demonstrated infiltrations of lymphocytes, plasma cells, and EOS in small bronchial mucosa tissues (Figure 1(c)).
case_images: Immunofluorescence detection confirming co-localization of CEACAM5 and RNase3. CEACAM5 (green signal) is distributed within the cytoplasm of certain RNase3-positive cells (red signal) in nasal polyps (Case 1: first row, low-power magnification; second row, high-power magnification). In nasal polyps and bronchial wall tissue (Case 3: third row and fifth row, low-power magnification; fourth row and sixth row, high-power magnification), CEACAM5-positive cells (green signal) are co-localized with RNase3-positive cells (red signal). Scale bar: 100 mum in low-power magnification and 40 mum in high-power magnification.. CEACAM5: carcinoembryonic antigen-related cell adhesion molecules 5; DAPI: 4',6-diamidino-2-phenylindole; RNase3 (also known as eosinophil cationic protein): ribonuclease 3.
case_images: 10.1177_2050313X241261152-fig2.jpg
case_images: PMC11181888_03_10.1177_2050313X241261152-fig2.jpg
case_images: fig2-2050313X241261152
case_images: Subsequent immunofluorescence double labeling demonstrated that some CEACAM5-positive cells were co-localized with RNase3-positive cells in nasal polyps (Figure 2), and at that time, her IgE level was 142 IU/ml. Immunofluorescence staining revealed the colocalization of RNase3-positive cells and CEACAM5-positive cells in bronchial tissue (Figure 2). Immunofluorescence detection in both cases confirmed the co-localization of CEACAM5 and RNase3, suggesting that CEA was expressed in EOS in AHCEAS patients (Figure 2).
case_images: PMC11181888_02
case_images: Variations in CEA and EOS in the case series from the initial admission. Line charts (a)-(c) illustrate the variations in EOS (orange line) and CEA (blue line) levels for Cases 1-3, respectively, from their initial admission. Serum CEA levels consistently mirrored the trends in blood EOS counts, and both parameters decreased following systemic corticosteroid therapy. By contrast, prior to systemic corticosteroid treatment (red arrow), the use of inhaled corticosteroids with or without bronchodilators (yellow arrow) showed less effectiveness. The size of the arrow indicates the dosage of corticosteroids administered.. CEA: carcinoembryonic antigen; EOS: eosinophil.
case_images: 10.1177_2050313X241261152-fig3.jpg
case_images: PMC11181888_03_10.1177_2050313X241261152-fig3.jpg
case_images: fig3-2050313X241261152
case_images: The relationship between serum CEA and blood EOS levels, along with the timeline of corticosteroid use, is shown in Figure 3.
case_images: Comparison of pulmonary imaging in Cases 2 and 3 before and after treatment. (a) Chest X-ray of Case 2 before prednisone therapy, illustrating inflammation in the middle lobe of the right lung with incomplete bronchial occlusion of the middle lobe. (b) Chest X-ray of Case 2 after 6 weeks of prednisone therapy shows the substantial resolution of the original inflammation in the right middle lobe. (c) Chest computed tomography (CT) scan of Case 3 before prednisone therapy reveals the bronchial occlusion in the dorsal segment of the left lower lung and complete consolidation with atelectasis in the left lower lung. (d) Chest CT scan of Case 3 after 3 months of prednisone therapy, indicating alleviation of atelectasis in the left lower lung.
case_images: 10.1177_2050313X241261152-fig4.jpg
case_images: PMC11181888_03_10.1177_2050313X241261152-fig4.jpg
case_images: fig4-2050313X241261152
case_images: On August 25, 2020, the patient was admitted for incidentally finding lung nodules and segmental atelectasis of the left lower lobe by CT thorax (Figure 4(c)). In September 2021, a deterioration of cough was noted along with the progression of lung lesions, as CT scans revealed nearly complete atelectasis of the left lower lobe (Figure 4(c)). CT thorax showed significant improvement as well as resuming lung volume of the left lower lobe (Figure 4(d)). Currently, she continues to receive prednisone with a maintenance dose of 10 mg daily.
case_images: PMC11181888_03
case_images: H&E staining of biopsy specimens in Cases 1 and 3. (a) Eosinophil infiltration (red arrow) and plasma cell presence (blue arrow) beneath nasal polyp mucosa (Case 1, magnification x10). (b) Abundant eosinophilic infiltrates (red arrow) within nasal polyp tissues (Case 3, magnification x10). (c) Evidence of lymphocyte, plasma cell, and eosinophil infiltration (red arrow) in small bronchial mucosa tissues (Case 3, magnification x10).. H&E: hematoxylin and eosin.
case_images: 10.1177_2050313X241261152-fig1.jpg
case_images: PMC11181888_03_10.1177_2050313X241261152-fig1.jpg
case_images: fig1-2050313X241261152
case_images: In 2018, the patient underwent pansinusectomy at our hospital, and the pathology results revealed EOS infiltration in the resected tissues (Figure 1(b)). Bronchoscopy was then performed, and transbronchial lung biopsy from the left lower lobe demonstrated infiltrations of lymphocytes, plasma cells, and EOS in small bronchial mucosa tissues (Figure 1(c)).
case_images: Immunofluorescence detection confirming co-localization of CEACAM5 and RNase3. CEACAM5 (green signal) is distributed within the cytoplasm of certain RNase3-positive cells (red signal) in nasal polyps (Case 1: first row, low-power magnification; second row, high-power magnification). In nasal polyps and bronchial wall tissue (Case 3: third row and fifth row, low-power magnification; fourth row and sixth row, high-power magnification), CEACAM5-positive cells (green signal) are co-localized with RNase3-positive cells (red signal). Scale bar: 100 mum in low-power magnification and 40 mum in high-power magnification.. CEACAM5: carcinoembryonic antigen-related cell adhesion molecules 5; DAPI: 4',6-diamidino-2-phenylindole; RNase3 (also known as eosinophil cationic protein): ribonuclease 3.
case_images: 10.1177_2050313X241261152-fig2.jpg
case_images: PMC11181888_03_10.1177_2050313X241261152-fig2.jpg
case_images: fig2-2050313X241261152
case_images: Subsequent immunofluorescence double labeling demonstrated that some CEACAM5-positive cells were co-localized with RNase3-positive cells in nasal polyps (Figure 2), and at that time, her IgE level was 142 IU/ml. Immunofluorescence staining revealed the colocalization of RNase3-positive cells and CEACAM5-positive cells in bronchial tissue (Figure 2). Immunofluorescence detection in both cases confirmed the co-localization of CEACAM5 and RNase3, suggesting that CEA was expressed in EOS in AHCEAS patients (Figure 2).
case_images: Variations in CEA and EOS in the case series from the initial admission. Line charts (a)-(c) illustrate the variations in EOS (orange line) and CEA (blue line) levels for Cases 1-3, respectively, from their initial admission. Serum CEA levels consistently mirrored the trends in blood EOS counts, and both parameters decreased following systemic corticosteroid therapy. By contrast, prior to systemic corticosteroid treatment (red arrow), the use of inhaled corticosteroids with or without bronchodilators (yellow arrow) showed less effectiveness. The size of the arrow indicates the dosage of corticosteroids administered.. CEA: carcinoembryonic antigen; EOS: eosinophil.
case_images: 10.1177_2050313X241261152-fig3.jpg
case_images: PMC11181888_03_10.1177_2050313X241261152-fig3.jpg
case_images: fig3-2050313X241261152
case_images: The relationship between serum CEA and blood EOS levels, along with the timeline of corticosteroid use, is shown in Figure 3.
case_images: Comparison of pulmonary imaging in Cases 2 and 3 before and after treatment. (a) Chest X-ray of Case 2 before prednisone therapy, illustrating inflammation in the middle lobe of the right lung with incomplete bronchial occlusion of the middle lobe. (b) Chest X-ray of Case 2 after 6 weeks of prednisone therapy shows the substantial resolution of the original inflammation in the right middle lobe. (c) Chest computed tomography (CT) scan of Case 3 before prednisone therapy reveals the bronchial occlusion in the dorsal segment of the left lower lung and complete consolidation with atelectasis in the left lower lung. (d) Chest CT scan of Case 3 after 3 months of prednisone therapy, indicating alleviation of atelectasis in the left lower lung.
case_images: 10.1177_2050313X241261152-fig4.jpg
case_images: PMC11181888_03_10.1177_2050313X241261152-fig4.jpg
case_images: fig4-2050313X241261152
case_images: On August 25, 2020, the patient was admitted for incidentally finding lung nodules and segmental atelectasis of the left lower lobe by CT thorax (Figure 4(c)). In September 2021, a deterioration of cough was noted along with the progression of lung lesions, as CT scans revealed nearly complete atelectasis of the left lower lobe (Figure 4(c)). CT thorax showed significant improvement as well as resuming lung volume of the left lower lobe (Figure 4(d)). Currently, she continues to receive prednisone with a maintenance dose of 10 mg daily.