In a patient with chronic eosinophilic pneumonia, chest X-ray typically shows the 'photographic negative' of pulmonary oedema. This means:

• A Hilar lymphadenopathy without parenchymal infiltrates
• B Bilateral lower-lobe consolidation sparing the upper zones
• C Unilateral pleural effusion with contralateral consolidation
• D Peripheral bilateral consolidation rather than central perihilar consolidation ✓

Explanation

Chronic eosinophilic pneumonia produces a distinctive 'photographic negative of pulmonary oedema' on chest X-ray: bilateral peripheral (subpleural) consolidation predominantly in the upper and mid zones, whereas pulmonary oedema produces central perihilar ('bat-wing' or 'butterfly') opacity. This peripheral distribution reflects the eosinophilic infiltrate hugging the lung periphery. The pattern is sufficiently characteristic to suggest the diagnosis in the appropriate clinical context.

Reference: Grainger & Allison's Diagnostic Radiology, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.