Empiric Treatment of Focal Organizing Pneumonia in a Patient with a Low-Risk Lung Mass

Abstract

The authors present a case of a 57-year-old man presenting with a solitary lung mass. Transbronchial biopsy showed an organizing pneumonia pattern. A therapeutic trial of corticosteroids resulted in complete resolution avoiding surgery. The authors discuss the diagnosis of focal organizing pneumonia without surgical resection.

Diagnostic approach to localised organising pneumonia: A case report

“…In our patient, it resulted in a radiological regression of bilateral lung lesions. Bronchoscopy confirmed FOP is treated by corticotrherapy, resulting in elimination of the symptoms and radiological regression 5 . In a study on LOP, patients with bilateral lesions were operated to establish the diagnosis, and due to bilateral lesions they were prescribed for corticotherapy which improved their condition, correlating to our reported case.…”

“…The radiological finding is presented with multiple, bilateral, patchy, peripheral alveolar shadows, ground glass or consolidation. More rarely, the radiological finding is presented with bilateral diffuse infiltrates and focal solitary lesions 1,2,5 . Focal COP is a rare entity, which may radiologically mimic malignant lung lesions and lung cancer.…”

“…Focal COP is a rare entity, which may radiologically mimic malignant lung lesions and lung cancer. In most focal OP (FOP) cases, the diagnosis is established only after a surgical resection due to a suspected malignancy 1,2,5 . Tiny nodular shadows are more frequent, found in 10-50% of patients, while huge nodular lesions are rare 6 .…”

“…The diagnosis of COP is established on the basis of the histopathological OP finding, clinical and radiological characteristics, having excluded the known agents or comorbid conditions 7 . The sample for histopathology may be obtained by transbronchial biopsy (TBB), but video-assisted thoracoscopy (VATS) is not rarely indicated as the method providing a sufficient lung tissue sample 1,2,5 .…”