Eosinophilic Lung Diseases

Eosinophilic lung disease (ELD) comprises a group of disorders that affect the lungs and manifest with blood and/or tissue eosinophilia. ELD may be secondary to a variety of conditions such as infection by parasites (e.g. ascariasis, strongyloidiasis, paragonimiasis, etc.), drug reaction, bronchopulmonary aspergillosis (ABPA) and malignancy. ELD may also be a primary process either limited to the lung (e.g. acute and chronic eosinophilic disease) or as part of a systemic disorder (e.g. allergic granulomatosis with polyangiitis or hypereosinophilic syndrome). On imaging ABPA is characterized by tubular branching opacities that may exhibit the finger-in-glove sign (i.e. inspissated mucus within dilated central bronchi). Strongyloidiasis often manifests with multifocal pulmonary opacities affecting all pulmonary lobes. AEP may simulate cardiogenic pulmonary edema on imaging. Chronic eosinophilic pneumonia (CEP) may have varied imaging manifestations, including the so-called “photographic negative of pulmonary edema”.