PMC3617889_01
Endoscopic and histologic images showing active EoE. a The endoscopic view shows a narrow-caliber and strictured proximal esophagus with prominent rings, linear furrows, and decreased mucosal vascularity. b The histologic view (40x) of the esophageal biopsy specimen demonstrates a marked eosinophilic infiltrate in the mucosa as well as basal layer hyperplasia and spongiosis.
crg-0007-0082-g01.jpg
PMC3617889_01_crg-0007-0082-g01.jpg
F1
His disease course had been complicated by an esophageal stricture which was 12 mm in narrowest diameter (fig. 1a), requiring multiple balloon dilations up to 15 mm in diameter. Despite treatment with high-dose swallowed fluticasone (880 mug twice daily) and then oral viscous budesonide (1 mg twice daily) over a 9-month period, he had ongoing dysphagia and persistently high levels of esophageal eosinophilia on follow-up biopsy (>100 eosinophils per high-power field) (fig. 1b).
CT angiography demonstrating multiple segmental pulmonary emboli and subsequent pulmonary infarct. a A filling defect consistent with PE is noted in the left lower lobe segmental artery (arrow). b A filling defect consistent with PE is noted in the right lower lobe segmental artery (arrow). c Another filling defect noted in the left lower lobe segmental artery (arrow). d Patchy opacities seen in left lower lobe most consistent with pulmonary infarct.
crg-0007-0082-g02.jpg
PMC3617889_01_crg-0007-0082-g02.jpg
F2
PE (fig. 2a-c). Patchy opacities at the left lung base were felt to represent pulmonary infarct (fig. 2d).