Acute Fibrinous and Organizing Pneumonia: A Case Report and Review of the Literature

Abstract

Background Acute fibrinous and organizing pneumonia is an unusual histopathological pattern of acute lung injury. To improve the understanding of acute fibrinous and organizing pneumonia, we herein present one case of a patient with acute fibrinous and organizing pneumonia proven by percutaneous lung biopsy along with clinical features, chest imaging and pathology. Case presentation A 70-year-old man was admitted to our department and was initially diagnosed to have community-acquired pneumonia. He had no specific symptoms and signs on presentation. Chest computed tomography scan showed a high-density shadow in the right basement of the lower lobe. The patient was preliminarily diagnosed with community-acquired pneumonia; however, antibacterial treatment was ineffective. To confirm the diagnosis, we performed twice percutaneous lung biopsy, and pathology was consistent with acute fibrinous and organizing pneumonia. After he was treated with glucocorticoids, the shadow seen on imaging dissipated during the follow-up period. Conclusion Acute fibrinous and organizing pneumonia is a rare histopathological diagnosis, which often has a delay in diagnosis. Clinicians need to consider the possibility of acute fibrinous and organizing pneumonia in the case of invalid antibacterial therapy. Further studies are needed to better classify acute fibrinous and organizing pneumonia, and characterise its clinical presentations, course and treatment.