0
Diffuse Lung Disease |

Cryptogenic Organizing Pneumonia Presenting as a Cavitary Mass

Joanne Martires, MD; Keren Fogelfeld, MD; Nikhil Barot, MD; Payman Fathizadeh, MD; Nader Kamangar, MD
Author and Funding Information

UCLA Olive View Medical Center, Sylmar, CA


Chest. 2014;146(4_MeetingAbstracts):394A. doi:10.1378/chest.1992412
Text Size: A A A
Published online

Abstract

SESSION TITLE: Interstitial Lung Disease Cases II

SESSION TYPE: Affiliate Case Report Slide

PRESENTED ON: Wednesday, October 29, 2014 at 11:00 AM - 12:15 PM

INTRODUCTION: Organizing pneumonia typically presents with patchy, alveolar, and migratory infiltrates on imaging. Other radiographic patterns include diffuse bilateral infiltrates and solitary opacities. Cavitary organizing pneumonia has been described in only a few case reports in the literature. We present a rare case of cryptogenic organizing pneumonia presenting as a cavitary mass.

CASE PRESENTATION: 52 year-old man with history of ischemic cardiomyopathy and diabetes presented with cough with brown sputum, subjective fevers, and shortness of breath for three weeks. He had taken a course of antibiotics without relief. He was originally from El Salvador and had a remote history of smoking. His pulmonary exam was significant for crackles in the right base and mild hypoxemia. He was afebrile and had no leukocytosis. Thoracic imaging was significant for a 5.7 x 5 cm cavitary mass at the right lower lobe with surrounding consolidation and ground glass opacities. The patient underwent a negative infectious workup and there was no evidence of malignancy. Bronchoscopy with transbronchial biopsies revealed multiple fibroplastic plugs (Masson bodies) in the alveoli consistent with organizing pneumonia. The patient was treated with systemic corticosteroids with near resolution of the cavitary mass and marked improvement in symptoms.

DISCUSSION: Organizing pneumonia is characterized by granulation tissue in the lumen of distal airspaces. It is an inflammatory response to alveolar and bronchial damage due an identifiable cause or may be idiopathic. Cavitary organizing pneumonia is very rare. Cavitary masses have a broad differential that includes necrotizing bacterial infections, fungi, mycobacteria, and primary or secondary malignancies. Organizing pneumonia can be an incidental finding in some of these disease processes. Therefore, when organizing pneumonia is found in the workup of a cavitary mass, an extensive workup for a potential underlying cause must be completed. In the case of our patient, no underlying cause of his cavitary mass or organizing pneumonia was identified. He was deemed to have cavitary cryptogenic organizing pneumonia. Histologic findings and his brisk response to steroids confirmed this diagnosis.

CONCLUSIONS: Organizing pneumonia presenting as a cavitary mass is rare and a diagnosis of exclusion; it should be considered in the differential of a cavitary mass.

Reference #1: Epler GR, Colby TV, McLoud TC, et al. Bronchiolitis obliterans organizing pneumonia. N Engl J Med 1985; 312: 152-158.

DISCLOSURE: The following authors have nothing to disclose: Joanne Martires, Keren Fogelfeld, Nikhil Barot, Payman Fathizadeh, Nader Kamangar

No Product/Research Disclosure Information


Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Topics

boop

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
PubMed Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543