Eosinophilic Granuloma of the Lungs

Roentgenologic and Pathologic Features

¹ Departments of Pathology and Radiology, City of Chicago Municipal Tuberculosis Sanitarium

Five patients with diffuse pulmonary disease thought to be tuberculosis, but proved on lung biopsy to be eosinophilic granuloma were admitted to the Municipal Tuberculosis Sanitarium in the last two years. The x-ray findings were those of a fine peribronchiolar lattice-work-like pattern of infiltration which, in later stages, became a mixture of fine nodular infiltrates and small cystic areas, leading eventually to the diagnosis of honeycomb lung. Predominant findings on microscopic examination of the lung tissue were the presence of granulomata consisting of histiocytic cells with a large number of eosinophils, histiocytic aggregates in the alveolar septa and bronchial walls and marked fibrosis of the lung with resulting bronchiolectasis. There was hyperplasia of the smooth muscle and epithelial elements. In our experience, confirmation of the diagnosis of eosinophilic granuloma hinges on the histologic examination of lung tissue taken for biopsy.