Amiodarone lung

Case contributed by David Pryde
Diagnosis certain

Presentation

Breathlessness

Patient Data

Age: 75 years
Gender: Female
x-ray

Patchy widespread lung infiltrates and previous cardiac surgery.

ct

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

Dense liver also - not shown.

Biopsy proven.

Case Discussion

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

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

  • secondary organizing 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 organizing pneumonia (BOOP), which is a disease specifically of small airways. 

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