Amiodarone lung

Case contributed by David Pryde
Diagnosis certain

Presentation

Breathlessness

Patient Data

Age: 75 years
Gender: Female
x-ray
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Info

Patchy widespread lung infiltrates and previous cardiac surgery.

ct
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Multiple patchy bilateral areas of lung consolidation tending towards the periphery with an occasional groundless area consistent with organising pneumonia.

Dense liver also - not shown.

Biopsy proven.

Case Discussion

Organising pneumonia (OP) is considered a non-specific repair process in lungs in response to various kinds of lung insults:

  • cryptogenic organising pneumonia (COP) when the cause is not known

  • secondary organising pneumonia when the cause is known

    • infection, inflammatory bowel disease, drugs (as in the above case), collagen vascular disease, organ transplantation and radiation direct to the chest

The histological hallmark of OP is intra-alveolar granulation tissue plugs (Masson bodies) which extend into bronchiolar lumina. The presence of these plugs is a prerequisite for restoration of tissue integrity.

Not to be confused with bronchiolitis obliterans organising pneumonia (BOOP), which is a disease specifically of small airways. 

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