CTICasesEosinophilic Granulomatosis with Polyangiitis (Churg-Strauss Syndrome)
Imaging findings
Chest CT shows patchy, centrally predominant ground-glass opacities representing diffuse alveolar hemorrhage. A discrete, nodular soft-tissue lesion is present in the right lower lobe base, corresponding to a prior bronchoscopic transbronchial biopsy site (a bronchoscopy bite). CT of the sinuses shows mucosal thickening and bony erosion. Biopsy shows eosinophilic and lymphocytic infiltration.
Key takeaways
Eosinophilic granulomatosis with polyangiitis (EGPA) is a systemic small-vessel vasculitis characterized by asthma, peripheral eosinophilia, and necrotizing granulomatous inflammation. In the lungs, it frequently presents with transient or recurrent ground-glass opacities from hemorrhage. Bronchial biopsy sites can appear on post-procedure CT as discrete, focal nodular lesions (bronchoscopy bites) and should not be mistaken for progressive disease.
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