PMC6446216_01
Diffuse centrilobular ground-glass nodules along the bronchovascular structures in apical and mid lung distribution.
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A follow-up high-resolution CT chest showed subtle centrilobular ground-glass nodules along the bronchovascular structures most pronounced within the bilateral mid and upper lungs (Fig. 1).
A (on top) and Fig. 2 B (on bottom): This histology shows prominent eosinophilic infiltrate, granulomatous reaction within and around small arteries or arterioles, so called eosinophilic vasculitis (A, 40X), eosinophilic microabscesses (B, 200X).
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Transthoracic lung biopsy was pursued and subsequent histopathological analysis showed prominent eosinophilic infiltrate, granulomatous reaction around small arterioles with occasional multinucleated giant cells and eosinophilic microabscesses, consistent with granulomatosis with polyangiitis and eosinophilia (Fig. 2A and B).