Published in:
12-09-2023 | Chronic Inflammatory Bowel Disease | Clinical Image
Lung Nodules in a 24-Year-Old Male with Crohn’s Disease
Published in: Journal of General Internal Medicine | Issue 15/2023
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A 24-year-old male with Crohn’s disease presented with shortness of breath. Computed tomography imaging of the chest revealed bilateral pulmonary nodules with varying degrees of cavitation (Fig. 1). Nodule pathology showed central abscess and necrosis with surrounding inflammation and fibrosis (Fig. 2). Infectious and rheumatologic workup was negative, including Gram and acid-fast stains of the biopsy specimen. Presentation, imaging, and pathology were felt to be consistent with necrobiotic pulmonary nodules secondary to inflammatory bowel disease (IBD). Initiation of glucocorticoids resulted in rapid improvement, and the patient was discharged with close follow-up.
Figure 1
Axial CT imaging of the lungs demonstrating multiple solid (white arrow) and cavitary (black arrow) nodules, some with internal solid components.
Figure 2
Biopsy demonstrating central abscess and necrosis (arrowheads, A and B) and adjacent palisading histiocytes (short arrows, A) with surrounding area of chronic inflammation (long arrows, B).
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