Pneumothorax as the Initial Manifestation of Idiopathic Hypereosinophilic Syndrome Yu-Bing Wang, MD, Ya-Juan Han, MD, Kenzo Uchida, MD, PhD, Bing-Cheng.

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Pneumothorax as the Initial Manifestation of Idiopathic Hypereosinophilic Syndrome Yu-Bing Wang, MD, Ya-Juan Han, MD, Kenzo Uchida, MD, PhD, Bing-Cheng Zhao, Ke-Bing Chen, MD, PhD, Wei-Ying Ma, MD, Feng- Jiao Xie, Tie-Lian Liu, MD, Li-Xi Zhang, MD The Annals of Thoracic Surgery Volume 98, Issue 5, Pages 1838-1841 (November 2014) DOI: 10.1016/j.athoracsur.2013.12.078 Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 (A) Chest plain X-ray film on admission showed left pneumothorax. (B) High-resolution computed tomography scan showed focal opacity in the left lower lobe and bilateral pleural effusions. The Annals of Thoracic Surgery 2014 98, 1838-1841DOI: (10.1016/j.athoracsur.2013.12.078) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 (A) Histopathologic examination of a biopsy taken from one skin lesion on the chest wall. Marked infiltration of eosinophils was seen in the fibroadipose tissue (hematoxylin-eosin, original magnification ×100). (B) Enlargement of boxed area in A; the fibroadipose tissue was edematous and contained eosinophilic infiltration, but no granuloma formation or signs of vasculitis (hematoxylin-eosin, original magnification ×400). (C) The bone marrow biopsy demonstrated increased proportion of eosinophils (arrowheads). The dark blue cells are lymphocytes or nucleated erythrocytes (hematoxylin-eosin, original magnification ×400). The Annals of Thoracic Surgery 2014 98, 1838-1841DOI: (10.1016/j.athoracsur.2013.12.078) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Chest radiograph showed dramatic improvement after corticosteroid therapy. The Annals of Thoracic Surgery 2014 98, 1838-1841DOI: (10.1016/j.athoracsur.2013.12.078) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions