CHEST 2023 On Demand Pass-Not all Lung Problems Start Within the Lungs

Video Transcription

Video Summary

A 40-year-old male with a history of rheumatoid arthritis and recent diagnosis of pyoderma gangrenosum presented with worsening right orbital swelling and diplopia. CT and MRI imaging showed orbital and sinus involvement. Autoimmune workup revealed positive ANA, SS-A antibodies, and PR3. A CT scan of the chest revealed a large lesion encasing the right bronchus. Bronchoscopy showed extrinsic compression of the bronchus. A biopsy of the orbital mass showed fibrosis and an onion skin appearance. A diagnosis of eosinophilic angiocentric fibrosis was made. The patient was started on steroids and had a good response to treatment with improvement seen on follow-up imaging. Eosinophilic angiocentric fibrosis is a rare condition that typically involves the orbit and upper respiratory tract, and its exact cause is unknown. Diagnosis is based on histopathology, and treatment involves excision and immunosuppressants. Recurrence is common, so close follow-up is necessary.

Meta Tag

Category Pulmonary Manifestations of Sy

Session ID 4013

Speaker Alex Dittrich

Speaker Samridhi Gulati

Speaker Sarah Mete

Speaker Vani Mulkareddy

Speaker Usama Nasir

Speaker Timothy Rowe

Track Pulmonary Manifestations of Systemic Disease

Keywords

40-year-old male

rheumatoid arthritis

pyoderma gangrenosum

right orbital swelling

diplopia

autoimmune workup

eosinophilic angiocentric fibrosis

onion skin appearance