Presentation
Presented to the GP with chronic cough. Patient had an incidental eosinophilia a year ago.
Patient Data
Patchy air space opacities in bilateral upper zones.
Reversed halo pattern (atoll sign): there are round focal areas of ground-glass attenuation with surrounding crescent or ring-shaped consolidation.
Case Discussion
Patient with organizing pneumonia shows a reversed halo pattern (atoll sign) where there are focal round areas of ground-glass attenuation with surrounding crescent or ring-shaped consolidation. This pattern of predominantly peripheral mid and upper zone organizing pneumonia can be seen in chronic eosinophilic pneumonia, a disease that presents with features of pneumonia but responds to corticosteroids. A history of asthma, peripheral blood eosiniphilia and eosinophilia on bronchoalveolar lavage are diagnostic.
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