Acute Fibrinous and Organizing Pneumonia with Myelodysplastic Syndrome: Corticosteroid Monotherapy Led to Successful Ventilator Weaning

Yamamoto, Mari; Murata, Ken‐ichiro; Kiriu, Takahiro; Kouzai, Yasuji; Takamori, Mikio

doi:10.2169/internalmedicine.55.6864

Cited by 10 publications

(9 citation statements)

References 13 publications

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“…Yamamoto et al had described a patient already diagnosed years before MDS presenting with fever, lung infiltrates, and lymphocytopenia with a histological pattern typical of AFOP. Although the patient initially responded well to corticosteroids and was discharged from the hospital, he died 5 months later ( 14 ), unlike our patient who is still in good condition 1.5 years after the episode.…”

Section: Discussioncontrasting

confidence: 64%

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Case Report: Diagnosis of Myelodysplastic Syndrome in a 72-Year-Old Female With Interstitial Lung Disease

et al. 2021

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Acute fibrinous and organizing pneumonia (AFOP) is an entity that can be secondary to various conditions leading to lung injury, such as infections, malignancies, and various autoimmune conditions or idiopathic interstitial lung disease, when no obvious underlying cause is identified. Myelodysplastic syndromes (MDS), on the other hand, are a spectrum of clonal myeloid disorders, with a higher risk of acute leukemia, characterized by ineffective bone marrow (BM) hematopoiesis and, thus, peripheral blood (PB) cytopenias. Immune deregulation is thought to take part in the pathophysiology of the disease, including abnormal T and/or B cell responses, innate immunity, and cytokine expression. In the literature, there are a few case reports of patients with MDS that have presented pulmonary infiltrates and were diagnosed as having AFOP or organizing pneumonia (OP). It is rare, though, to have isolated pulmonary infiltrates without Sweet's syndrome or even the pulmonary infiltrates to precede the diagnosis and treatment of MDS, which was our case. We present a 72-year-old female developing new lung infiltrates refractory to antibiotic treatment that responded well to corticosteroids and was histologically described as having OP. The treatment was gradually successfully switched to mycophenolate mofetil (MMF). The patient was later diagnosed with MDS. This interesting case report suggests firstly that a diagnosis of AFOP or OP should alert the clinician to search for an underlying cause including MDS and vice versa, the use of systemic steroids should not be postponed, and, finally, that MMF can successfully be used in these patients.

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Section: Discussioncontrasting

confidence: 64%

“…These cases are mostly treated and are responsive to steroids, and relapses are usual with their reduction. The need for mechanical ventilation, ventilatory failure, and fatality are not rare (10)(11)(12)(13)(14)(15).…”

Section: Introductionmentioning

confidence: 99%

Case Report: Diagnosis of Myelodysplastic Syndrome in a 72-Year-Old Female With Interstitial Lung Disease

et al. 2021

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“…Furthermore, our present study detected a high frequency of OP in MDS with der(1;7)(q10;p10) in comparison with the frequency in MDS without the mutation. Five cases of der(1;7)(q10;p10)‐harbouring MDS with the complication of OP have been reported to date 5–9 . Further study is required to confirm if der(1;7)(q10;p10) is a risk factor for developing OP in MDS.…”

Section: Figurementioning

confidence: 99%

The clinicopathological analysis of organising pneumonia in myelodysplastic syndrome: high frequency in der(1;7)(q10; p10)

et al. 2021

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“…The ablation zones dissected were along the axis of bronchus where the antenna inserted and Dl, Ds were measured. Each vivo ablated zone was then stored in 10% formalin for paraffin sectioning, hematoxylin-eosin (HE) staining, Terminal deoxynucleotidyl transferase mediated dUTP nick end labeling (TUNEL) staining assay, Masson trichrome staining for microscopic study were performed by pathologists, as previously described (21,22).…”

Section: Ablation By Antenna Through the Working Channel Of Bronchoscopy In Ex Vivo And In Vivo Lungmentioning

confidence: 99%

Flexible bronchoscopy-guided microwave ablation in peripheral porcine lung: a new minimally-invasive ablation

Yuan¹,

Wang²,

Sun³

et al. 2019

Transl Lung Cancer Res

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Background: Transbronchial lung biopsy is an important approach to diagnose peripheral lung cancer, but bronchoscopy based treatment options are limited and poorly studied. A flexible bronchoscopy-guided water-cooled microwave ablation (MWA) catheter was developed to evaluate the feasibility and safety both in ex vivo and in vivo porcine models.Methods: Using direct penetration of the catheter through the surface of ex vivo porcine lung, ablations (n=9) were performed at 70, 80, 90 W for 10 minutes. Temperatures of the catheter and 10, 15, 20 mm away from the tip were measured. Under bronchoscopy conditions in porcine lung, ablations (n=18, 6 in ex vivo and 12 in vivo) were performed at 80 W for 5 minutes. Computed tomography (CT) was acquired perioperative, 24 hours, 2 weeks, and 4 weeks post ablation. Ablation zones were excised at 24 hours and 4 weeks respectively. Long-axis diameter (Dl) and short-axis diameter (Ds) were measured and tissues were sectioned for pathological examination.Results: In-ex vivo lung, the temperature at 20 mm removed was over 60 ℃ at 80 W for 288±26 seconds.The ablations under bronchoscopic conditions were successful in-ex vivo and in vivo lung. No complications occurred during the procedures. Coagulation necrosis was visible at 24 hours, and repaired fibrous tissue was seen at 4 weeks. Conclusions:The flexible bronchoscopy-guided water-cooled MWA is feasible and safe. This early animal data holds promise of MWA becoming a potential therapeutic tool for Peripheral Lung Cancers.

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Acute Fibrinous and Organizing Pneumonia with Myelodysplastic Syndrome: Corticosteroid Monotherapy Led to Successful Ventilator Weaning

Cited by 10 publications

References 13 publications

Case Report: Diagnosis of Myelodysplastic Syndrome in a 72-Year-Old Female With Interstitial Lung Disease

Case Report: Diagnosis of Myelodysplastic Syndrome in a 72-Year-Old Female With Interstitial Lung Disease

The clinicopathological analysis of organising pneumonia in myelodysplastic syndrome: high frequency in der(1;7)(q10; p10)

Flexible bronchoscopy-guided microwave ablation in peripheral porcine lung: a new minimally-invasive ablation

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