Two patients with new granulomatous lung lesions during treatment of Crohn's disease

Satoshi Takeda; Takanori Akagi; Hiroyuki Miyazaki; Masaru Kodama; Satoshi Yamamoto; Takahiro Beppu; Takashi Nagahama; Toshiyuki Matsui; Kentaro Watanabe; Nobuhiko Nagata

doi:10.1016/j.rmcr.2014.02.002

Two patients with new granulomatous lung lesions during treatment of Crohn's disease

Respir Med Case Rep. 2014 Feb 22:12:16-8. doi: 10.1016/j.rmcr.2014.02.002. eCollection 2014.

Authors

Affiliations

¹ Department of Respiratory Medicine, Fukuoka University Chikushi Hospital, Japan ; Department of Respiratory Medicine, Fukuoka University Hospital, Japan.
² Department of Respiratory Medicine, Fukuoka University Chikushi Hospital, Japan.
³ Department of Surgery, Fukuoka University Chikushi Hospital, Japan.
⁴ Department of Gastroenterology, Fukuoka University Chikushi Hospital, Japan.
⁵ Department of Respiratory Medicine, Fukuoka University Hospital, Japan.

Abstract

Two patients with granulomatous lung lesions thought to be related to Crohn's disease (CD) are reported. Patient 1 was a 43-year-old man who was diagnosed with CD at age 11 years. He developed a fever in the 38 °C, and a chest X-ray and CT scan showed infiltrates with air bronchograms in the right upper lobe and left lingular segment. Transbronchial lung biopsy (TBLB) revealed granulomatous lesions. Patient 2 was a 76-year-old woman who was diagnosed with CD at age 44 years. Chest CT showed infiltrates and nodular shadows in both lung fields. Video-assisted thoracoscopic surgery (VATS) in June 2012 revealed granulomatous lesions. Tuberculosis, fungal infections, drug-induced lung disorder, and sarcoidosis were ruled out as a cause of the granulomatous lesions in both patients. The aetiology was thought to be CD.

Keywords: Crohn's disease; Granulomatous lung lesions; Sarcoidosis.