CTICasesMethotrexate-Induced Eosinophilic Pleuritis
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Imaging findings
Chest CT shows progressive, large, bilateral, loculated pleural effusions without pericardial effusion, while the lung parenchyma remains clear. Thoracoscopic decortication yielded thick pleural fluid and tissue almost entirely composed of eosinophils and degranulated eosinophils.
Key takeaways
Eosinophilic pleuritis is a rare inflammatory pleural reaction characterized by a high concentration of eosinophils in the pleural fluid or tissue. It can occur as a rare drug reaction, particularly associated with long-term methotrexate therapy, or as a manifestation of systemic lupus erythematosus. Treatment may involve stopping the offending drug or administering corticosteroid therapy.
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