Necrobiotic pulmonary nodules - Crohn disease

Case contributed by Dr Maxime St-Amant

Presentation

Cough. Known for Crohn disease.

Patient Data

Age: 35 years
Gender: Female

There are bilateral lung nodules involving the upper third and inferior third of the right lung, and the upper third of the left lung. Some of these opacities are cavitating, with a radiolucent central component.

Multiple bilateral cavitary lung nodules are seen, surrounded by ground-glass opacities, which remains non-specific. Necrobiotic pulmonary nodules must be considered in patient with Crohn's disease after exclusion of other differential diagnoses.

Case Discussion

This is a rare case of cavitary lung nodules in a patient with Crohn's disease. Treatment with corticosteroid is usually very effective, and follow-up CT-scan may even normalize.

The differential diagnosis, in this case, is done using the CAVITY mnemonic. Drug-induced lung disease must be kept in mind in patient with Crohn's disease, since they are often treated with multiple drugs.

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