Whipple disease (thoracic manifestations)
Thoraco-pulmonary manifestations of Whipple disease are uncommon and may result in later course of disease.
Lung involvement is seen in 35-60% of patients with gastrointestinal whipple disease. Males are affected eight times than of females.
Grossly there are areas of consolidation around bronchovascular channels which appear similar to the sarcoidosis. Histologically there are PAS positive inclusion bodies in the macrophages within the lesion.
Majority of patients present with non specific pulmonary and general symptoms like chronic non productive cough, pleuritic chest pain, dyspnoea, progressive weight loss, anorexia, malaise, arthralgia and intermittent fever.
Various patterns can be observed in pulmonary whipple disease which may include
- diffuse or focal pulmonary infiltrates
- basal lung opacities
- nodular lesions
- pleural adhesions
- pleural effusion
CT may reveal basal infiltrates, soft tissue nodules, mediastinal and hilar lymphadenopathy.
- 1. Kelly CA, Egan M, Rawlinson J. Whipple's disease presenting with lung involvement. Thorax. 1996;51 (3): 343-4. Free text at pubmed - Pubmed citation
- 2. Urbanski G, Rivereau P, Artru L et-al. Whipple disease revealed by lung involvement: a case report and literature review. Chest. 2012;141 (6): 1595-8. doi:10.1378/chest.11-1812 - Pubmed citation
- 3. Symmons DP, Shepherd AN, Boardman PL et-al. Pulmonary manifestations of Whipple's disease. Q. J. Med. 1985;56 (220): 497-504. Pubmed citation
- 4. Zander DS, Farver CF. Pulmonary Pathology. Churchill Livingstone. (2008) ISBN:0443067414. Read it at Google Books - Find it at Amazon
- 5. Wright FW. Radiology of the Chest and Related Conditions. CRC Press. (2001) ISBN:0415281415. Read it at Google Books - Find it at Amazon