Cryptogenic organising pneumonia

Case contributed by Dr Henry Knipe

Presentation

Admitted with CAP poorly responsive to oral antibiotics. Three month history fevers, LOW and left chest pain.

Patient Data

Age: 60
Gender: Male
Modality: CT

Spiculated pleurally-based mass in the left lower lobe. There are multiple further pulmonary nodules.

In the dependent aspects of the left upper lobe is areas of interlobular septal thickening and dependent consolidation. Consolidation in peribronchovascular pattern in the right lower lobe with further mass lesions and regional architectural distortion with interlobular septal thickening.

Remainder of the lungs are emphysematous. Left-sided pleural thickening but no definite pleural effusion. Hilar and mediastinal enlarged lymph nodes.

Hepatosplenomegaly in keeping with history of myelodysplasia.

Conclusion:

Mixed pattern of pulmonary disease with cryptogenic organising pneumonia (COP) to be considered most likely followed by chronic eosinophilic pneumonia. Infection is considered less likely. 

Case Discussion

The patient was admitted under the respiratory unit and was diagnosed with COP. He started steroid for treatment with mixed benefit. 

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Case Information

rID: 39151
Case created: 21st Aug 2015
Last edited: 30th Aug 2015
System: Chest
Inclusion in quiz mode: Included

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