Humpath.com - Human pathology

Home > E. Pathology by systems > Respiratory system > Lungs > pulmonary Crohn disease

pulmonary Crohn disease

Tuesday 8 February 2005

Noninfectious pulmonary disease in patients with Crohn’s disease has variable histologic appearances, including granulomatous inflammation and airway-centered disease resembling that seen in patients with ulcerative colitis.

Drugs may contribute to pulmonary disease in some patients.

IBIDs

Patients with chronic inflammatory bowel disease (chronic ulcerative colitis and Crohn’s disease) may have a variety of extraintestinal manifestations, including arthritis, ankylosing spondylitis, erythema nodosum, pyoderma gangrenosum, dermatitis, aphthous stomatitis, conjunctivitis, episcleritis, uveitis, hepatitis, pericholangitis, sclerosing cholangitis, primary biliary cirrhosis, pancreatitis, thyroiditis, pyelitis, and pericarditis.

Pulmonary complications of chronic ulcerative colitis are best known and include bronchitis, bronchiectasis, bronchiolitis obliterans organizing pneumonia, nodular suppuration (characterized histologically by airspace accumulations of neutrophils that undergo central necrosis and cavitation), and pulmonary vasculitis.

Radiology

- diffuse infiltrates
- bilateral nodular infiltrates
- mass

Pathology synopsis

- chronic bronchiolitis with non-necrotizing granulomatous inflammation.
- acute bronchiolitis associated with a neutrophil-rich bronchopneumonia with suppuration.
- cellular interstitial pneumonia with rare giant cells.
- organizing pneumonia with focal granulomatous features.

References

- Noninfectious lung pathology in patients with Crohn disease. Casey MB, Tazelaar HD, Myers JL, Hunninghake GW, Kakar S, Kalra SX, Ashton R, Colby TV. Am J Surg Pathol. 2003 Feb;27(2):213-9. PMID: 12548168