Organising pneumonia (OP)

Case contributed by Dr Domenico Nicoletti

Presentation

Dry cough, night sweats, fatigue, weight loss, anorexia for about thirty days. Non smoker.

Patient Data

Age: 48
Gender: Male
CT

Bilaterally in the lower lobes, in the middle lobe and the lingula are multifocal patchy parenchymal consolidations, with blurred margins associated with ground-glass opacity. 

CT

Three months later

Resolution of inflammatory infiltrates in the lower lobes and improved appearance in the upper lobe and middle lobe lateral segment. Atoll sign more appreciable in the apical segment of the lower lobes. Ground glass areas in the lower lobes, and in the left upper lobe.

Photo

Bronchoscopy with bronchoalveolar lavage and transbronchial biopsies:

Strips of lung parenchyma with fibrin in intermingled cells to granulocytes and inflammatory interstitial aggregates. Various formations polypoid endobronchial connective tissue is present. Occasional alveolar histiocytes.

Case Discussion

Organising pneumonia is classified as part of the idiopathic interstitial pneumonias and presents clinically with similar aspects to those of pneumonia. The inflammatory outbreaks may resolve spontaneously and then reform elsewhere, often more cranial, sometimes in the contralateral lung (migrating opacity).

Case courtesy: Prof Fabio Denicolò.

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Case information

rID: 48568
Case created: 14th Oct 2016
Last edited: 21st Oct 2016
System: Chest
Inclusion in quiz mode: Included

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