Imaging: Pulmonary Nodules |

A Case of Multiple Pulmonary Nodules in Association With Pyoderma Gangrenosum FREE TO VIEW

Liu Wei, MA
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The 1st Hospital of Ji Lin University, Chang Chun, China

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;149(4_S):A254. doi:10.1016/j.chest.2016.02.265
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SESSION TITLE: Pulmonary Nodules

SESSION TYPE: Case Report Slide

PRESENTED ON: Saturday, April 16, 2016 at 01:00 PM - 02:00 PM

INTRODUCTION: Pyoderma gangrenosum (PG) is a chronic inflammatory cutaneous disease of unknown etiology. Although it is basically considered to be a dermatological disease, its clinical appearance seems to be systemic in some aspects.

CASE PRESENTATION: A 63-year-old female retired office worker was admitted to the authors’ respiratory ward in November 23, 2012. She complained of cough and slight chest pain. CT scan showed bilateral infiltrative shadows accompanied by pleural effusion and pleural thickening on the right side (Fig. 1, 2). She was treated with oral antibiotics but the shadows did not change.

DISCUSSION: PG, first described by Brunsting and O’Leary in 1930, is a rare neutrophil, ulcerative, painful and non-infectious dermatosis, described as having a strong association with ulcerative colitis of unknown pathogenesis [1-3]. It is of fundamental importance to know this clinical association, so little known by dermatologists and radiologists, for more success in the diagnosis, treatment and follow-up of these patients.

CONCLUSIONS: This report describes a patient with pyoderma gangrenosum (PG), in whom there were co-existent lung abnormalities. The patient’s CT scan showed peripherally sited multiple pulmonary lesions bilaterally. A lung biopsy showed chronic non-specific inflammatory changes with neutrophil and lymphocyte infiltration which were similar to the skin lesions. This case was diagnosed as multiple aseptic nodules in PG.

Reference #1: Powell FC, Schroeter AL, Su WP, Perry HO. Pyoderma gangrenosum: a review of 86 patients. Q J Med. 1985;55(217):173-186.

Reference #2: Brunsting LA, Goeckerman WH, O'Leary PA. Pyoderma (echthyma) gangrenosum: clinical and experimental observations in five cases occurring in adults. Arch Dermatol Syph. 1930;22:655-680.

Reference #3: Berbert AL, Mantese SA, Rocha A, Rezende J, Cunha TF. [Superficial granulomatous pyoderma: report of a case of an uncommon variant of pyoderma gangrenosum]. An Bras Dermatol. 2009;84(3):285-288.

DISCLOSURE: The following authors have nothing to disclose: Liu Wei

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