Ann Rehabil Med.  2017 Jun;41(3):493-497. 10.5535/arm.2017.41.3.493.

Diagnosis of Churg-Strauss Syndrome Presented With Neuroendocrine Carcinoma: A Case Report

• Park D
• Lee HJ
• Lee KH
• Kwon BS
• Park JW
• Nam KY
• Lee KH

• KMID: 2389467
• DOI: http://doi.org/10.5535/arm.2017.41.3.493

Abstract

Churg-Strauss syndrome (CSS) is a rare systemic vasculitis that affect small and medium-sized blood vessels and is accompanied by asthma, eosinophilia, and peripheral neuropathy. This report describes a case of a 52-year-old man who had a history of sinusitis, asthma, and thymus cancer and who had complained of bilateral lower extremity paresthesia and weakness for a month. Peripheral neuropathy was detected by electrodiagnostic studies. Resection of a mediastinal mass, which was diagnosed as thymic neuroendocrine carcinoma, was performed five months before his visit. After thymectomy, peripheral blood tests revealed a gradual increase in eosinophils. Two months after surgery, he was admitted to the hospital for dyspnea, and nodules of focal consolidation were found in his chest X-ray. One month later, pyoderma occurred in the right shin, and the skin biopsy showed extravascular eosinophilic infiltration. He was diagnosed with CSS after thymectomy, and we report a very rare case of CSS presented with thymic neuroendocrine carcinoma.

Keyword

Churg-Strauss syndrome; Thymic neuroendocrine carcinoma; Polyneuropathy

MeSH Terms

Asthma
Biopsy
Blood Vessels
Carcinoma, Neuroendocrine*
Churg-Strauss Syndrome*
Diagnosis*
Dyspnea
Eosinophilia
Eosinophils
Hematologic Tests
Humans
Lower Extremity
Middle Aged
Paresthesia
Peripheral Nervous System Diseases
Polyneuropathies
Pyoderma
Sinusitis
Skin
Systemic Vasculitis
Thorax
Thymectomy
Thymus Neoplasms

Figure

• 

  Fig. 1 Paranasal sinus computed tomography in the coronal section showed sinusitis and mucosal thickening (asterisk).

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  Fig. 2 Mediastinal mass excisional biopsy (A) showed a composition of medium-sized polygonal cells with mild pleomorphism. Atypical mitosis is noted (black arrow) (H&E, ×720). Skin punch biopsy of right shin (B) showed extravascular eosinophil infiltration (H&E, ×400).

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  Fig. 3 Chest X-ray showed poorly defined nodules of focal consolidation in the right upper and lower lobes.

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