Organizing pneumonia: the many morphological faces

Oikonomou, Anastasia; Hansell, David M.

doi:10.1007/s00330-001-1211-3

Cited by 118 publications

(104 citation statements)

References 90 publications

(53 reference statements)

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“…Although CT was not available in 3 patients, the nodules of 10 patients in this study were located in the peripheral lung field, making contact with the pleural surface, and their shapes varied from wedge-shaped to round or spiculated nodules. These CT findings are compatible with those described by Oikonomou et al [18]. …”

Section: Discussionsupporting

confidence: 83%

Organizing Pneumonia Presenting as a Solitary Nodular Shadow on a Chest Radiograph

et al. 2003

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Background: The role of infection as a cause of focal organizing pneumonia (OP) is not fully understood. Objectives: This study aimed to determine the clinical, radiological and pathological characteristics of patients with OP presenting a solitary nodular shadow on a chest radiograph. Methods: Fourteen patients who presented with a solitary nodular shadow on a chest radiograph, pathologically diagnosed as OP after surgical resection, were allocated into two groups according to the histological findings. The first had OP with aggregates of neutrophils in airways and/or pulmonary parenchyma with or without necrosis or destruction of lung architecture (group 1: OP with neutrophilic infiltration; n = 10). The second consisted of patients with OP presenting neither neutrophilic infiltration, necrosis nor destruction of lung architecture (group 2: OP without neutrophilic infiltration; n = 4). Results: Cough, sputum, and chest pain were the common symptoms in both groups of patients. Computed tomography (CT) revealed that all nodules in both groups were located in the peripheral lung parenchyma and had irregular margins, and their shapes varied from round to wedge-shaped. Haemophilus influenzae was isolated from sputum or transbronchial aspirates from 3 patients in group 1. Conclusions: The specimens resected from patients with focal OP mostly show small aggregates of neutrophils. However, the dominant histological feature is OP and neutrophilic infiltration, suggesting infection was a minor histological component in all cases. Clinical symptoms and chest CT findings did not clearly distinguish these two groups of patients. It is thus reasonable to place these OPs in the same category and to treat them in the same way. Surgical excision appears to be the only method for a precise diagnosis.

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Section: Discussionsupporting

confidence: 83%

Organizing Pneumonia Presenting as a Solitary Nodular Shadow on a Chest Radiograph

et al. 2003

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“…Several other imaging features have been reported [108]. The nodular pattern may consist of a well-defined ''acinar'' pattern with nodules of ,8 mm in diameter, or of a more subtle poorly defined (micro)nodular pattern.…”

Section: Other Imaging Featuresmentioning

confidence: 99%

Cryptogenic organising pneumonia

Jf¹

2006

European Respiratory Journal

478

466

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Organising pneumonia is defined histopathologically by intra-alveolar buds of granulation tissue, consisting of intermixed myofibroblasts and connective tissue. Although nonspecific, this histopathological pattern, together with characteristic clinical and imaging features, defines cryptogenic organising pneumonia when no cause or peculiar underlying context is found. Rapid clinical and imaging improvement is obtained with corticosteroid treatment, but relapses are common after stopping treatment.

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“…Other than OP disease, t can be seen in vasculitis, bronchocentric granulomatosis, chronic eosinophilic pneumonia, hypersensitivity pneumonia, diffuse alveolar damage, nonspecific pneumonia, lung abscess, pulmonary infarct, and cancers, but as a minor finding [9]. OP can also coexist with fibrotic interstitial pneumonia as small foci [2].…”

Section: Discussionmentioning

confidence: 99%

“…A reversed halo sign is found at the rate of approximately 20%, and it is indicative of OP [9,14]. It can also appear as a diffuse bilateral infiltration or solitary focal mass lesion [11].…”

Section: Discussionmentioning

confidence: 99%