A rare cause of pulmonary nodules

Michael Tsuyoshi Chew, Eric W Chak, Karen Matsukuma

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Crohn's disease is a chronic, idiopathic autoimmune disorder that primarily targets the gastrointestinal (GI) system. It is characterized by transmural inflammation of the GI tract that can occur anywhere from the mouth to the anus. Not infrequently, the disease may also have extraintestinal manifestations (EIMs) that can affect almost any organ system. It is estimated that EIMs affect up to 36% of patients with Crohn's disease, but the incidence and prevalence of pulmonary involvement are variable in the literature and may be as low as 0.4%. There are few case reports documenting pulmonary manifestations, as they are often overlooked, especially if respiratory symptoms are present before the diagnosis of GI manifestations, as in the present case. A 44-year-old otherwise healthy woman presented with nonspecific respiratory complaints, recurrent pneumonias, and multiple computed tomography images showing diffuse, migratory, nodular, and consolidative parenchymal lung disease, with a largely unremarkable infectious and rheumatologic evaluation. Lung biopsy revealed necrotizing and nonnecrotizing granulomas, raising concern for sarcoidosis. Subsequent imaging revealed an incidental mass in the cecum. Biopsy of the cecum lesion revealed acute cryptitis, crypt abscess, and a single poorly formed granuloma, suggesting the possibility of Crohn's disease. In this report, we present a patient whose pulmonary manifestations ultimately led to the diagnosis of Crohn's disease.

Original languageEnglish (US)
Pages (from-to)633-639
Number of pages7
JournalCase Reports in Gastroenterology
Volume10
Issue number3
DOIs
StatePublished - Oct 6 2016

Fingerprint

Crohn Disease
Lung
Cecum
Granuloma
Biopsy
Anal Canal
Sarcoidosis
Abscess
Lung Diseases
Mouth
Gastrointestinal Tract
Pneumonia
Tomography
Inflammation
Incidence

Keywords

  • Crohn's disease
  • Extraintestinal manifestations
  • Pulmonary nodules

ASJC Scopus subject areas

  • Gastroenterology

Cite this

A rare cause of pulmonary nodules. / Chew, Michael Tsuyoshi; Chak, Eric W; Matsukuma, Karen.

In: Case Reports in Gastroenterology, Vol. 10, No. 3, 06.10.2016, p. 633-639.

Research output: Contribution to journalArticle

Chew, Michael Tsuyoshi ; Chak, Eric W ; Matsukuma, Karen. / A rare cause of pulmonary nodules. In: Case Reports in Gastroenterology. 2016 ; Vol. 10, No. 3. pp. 633-639.
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