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Multiple aseptic pulmonary nodules with central necrosis in association with pyoderma gangrenosum

S Krüger1, W Piroth, B Amo Takyi

  • 1Medical Clinic I, University Hospital, University of Technology, Aachen, Germany.

Chest
|March 13, 2001
PubMed

Insights

Pulmonary nodules, a rare manifestation of pyoderma gangrenosum, were observed in a patient with a history of skin lesions. Treatment with oral prednisolone led to rapid resolution of these lung nodules.

Area of Science:

  • Pulmonology
  • Dermatology
  • Pathology

Background:

  • Pyoderma gangrenosum (PG) is a rare neutrophilic dermatosis.
  • Pulmonary involvement in PG is exceptionally uncommon.
  • This case highlights a rare extrapulmonary manifestation of PG.

Observation:

  • A 45-year-old patient presented with multiple pulmonary nodules and central necrosis on CT scan.
  • The patient had a 4-year history of PG with minimal skin involvement.
  • Lung biopsy revealed nonspecific inflammatory aseptic necrosis, similar to skin lesions.

Findings:

  • CT-guided lung biopsy confirmed an inflammatory, necrotic process.
  • Histopathology of lung nodules mirrored that of PG skin lesions.
  • Pulmonary nodules in this case were attributed to pyoderma gangrenosum.

Implications:

  • This case expands the spectrum of known pulmonary manifestations of pyoderma gangrenosum.
  • Early recognition and treatment of pulmonary nodules in PG patients are crucial.
  • Systemic corticosteroids like prednisolone may be effective in managing pulmonary PG.

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