Synonyms
Reactive eosinophilic pleuritis; REP
Definition
Reactive eosinophilic pleuritis (REP) is a nonspecific florid reaction pattern to pleural injury seen in conjunction with 38–60% of patients with spontaneous pneumothorax. It is characterized by fibrin deposition on the parietal and/or visceral pleura with accompanying entrapped eosinophils, mononuclear cells with vesicular nuclei that are often folded, and occasional multinucleated giant cells.
One case series demonstrated that REP is associated in up to 28% of spontaneous pneumothorax cases with a graded spectrum of reactive eosinophilic pulmonary vascular infiltration. The pathophysiology is thought to be related to movement of eosinophils from the vessels to the pleural surface.
Imaging does not reveal any specific changes to REP and consists of changes seen with pneumothorax and any associated bullae or apical blebs.
It should be noted that while REP is a distinct entity from Langerhans cell histiocytosis (LCH), one...
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References and Further Reading
Askin, F. B., McCann, B. G., & Kuhn, C. (1977). Reactive eosinophilic pleuritis: A lesion to be distinguished from pulmonary eosinophilic granuloma. Archives of Pathology & Laboratory Medicine, 101(4), 187–191.
Luna, E., Tomashefski, J. F., Jr., Brown, D., Clarke, R. E., & Kleinerman, J. (1994). Reactive eosinophilic pulmonary vascular infiltration in patients with spontaneous pneumothorax. The American Journal of Surgical Pathology, 18(2), 195–199.
McDonnell, T. J., Crouch, E. C., & Gonzalez, J. G. (1989). Reactive eosinophilic pleuritis. A sequela of pneumothorax in pulmonary eosinophilic granuloma. American Journal of Clinical Pathology, 91(1), 107–111.
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Butt, Y.M. (2018). Reactive Eosinophilic Pleuritis. In: Allen, T.C., Suster, S. (eds) Pathology of the Pleura and Mediastinum. Encyclopedia of Pathology. Springer, Cham. https://doi.org/10.1007/978-3-319-66796-6_384
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DOI: https://doi.org/10.1007/978-3-319-66796-6_384
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