A Cryptogenic Case of Fulminant Fibrosing Organizing Pneumonia

Kobayashi, Takehiko; Kitaichi, Masanori; Tachibana, Kazunobu; Kishimoto, Yutaro; Inoue, Yasushi; Kagawa, Tomoko; Maekura, Toshiya; Sugimoto, Chikatoshi; Arai, Toru; Akira, Masanori; Inoue, Yoshikazu

doi:10.2169/internalmedicine.56.7371

Cited by 8 publications

(5 citation statements)

References 23 publications

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“…This distribution was evident in our case material where in the fibrosing DAD cases the alveolar duct connective tissue was replaced by dense collagen. A similar progression to dense collagen rich fibrosis from organizing connective tissue has also been described in organizing pneumonia under a variety of names such as fibrosing or cicatricial organizing pneumonia (49)(50)(51). The fibrosing lesions were sometimes associated with small cystic spaces.…”

supporting

confidence: 57%

Progression to fibrosing diffuse alveolar damage in a series of 30 minimally invasive autopsies with COVID‐19 pneumonia in Wuhan, China

Wang

et al. 2020

Histopathology

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Aims: Coronavirus Disease 2019 (COVID-19) caused by Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infection has been deemed as a global pandemic by World Health Organization. While diffuse alveolar damage (DAD) is recognized to be the primary manifestation COVID-19 pneumonia, there has been little emphasis on the progression to the fibrosing phase of DAD. This topic is of great interest due to growing concerns regarding the potential long-term complications in prolonged survivors. Methods: Here we report a detailed histopathologic study of thirty autopsy cases with COVID-19 virus infection, based on minimally invasive autopsies performed between February to March, 2020. Results: The mean age was 69 years, with twenty (67%) males and 10 (33%) females and frequent (70.0%) underlying comorbidities. The duration of illness ranged from 16 to 82 (median=42) days. Histologically, the most common manifestation was diffuse alveolar damage (DAD) in 28 (93.3%) cases which showed predominantly acute (32%), organizing (25%), and/or fibrosing (43%) patterns. Patients with fibrosing DAD were one decade younger (p=0.034) and they had a longer duration of illness (p=0.033), hospitalization (p=0.037) and mechanical ventilation (p=0.014) compared to those with acute DAD. Patients with organizing DAD had a longer duration of illness (p=0.032) and hospitalization (p=0.023) compared to those with acute DAD. Conclusions: COVID-19 pneumonia patients who develop DAD can progress to the fibrosing pattern. While we observed fibrosing DAD in fatal cases, whether surviving patients are at risk for developing pulmonary fibrosis and the frequency of this complication will require further clinical and radiologic follow-up studies.

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supporting

confidence: 57%

Progression to fibrosing diffuse alveolar damage in a series of 30 minimally invasive autopsies with COVID‐19 pneumonia in Wuhan, China

Wang

et al. 2020

Histopathology

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“…Histological OP has two subtypes, intraluminal type OP and incorporated type OP [18,19]. In recent reports, it was described that incorporated type OP was observed in patients of RPILD with DM and ASS [36,37]. Current study revealed for the first time that patients with influenza A (H1N1) pneumonia frequently demonstrate incorporated type OP as well.…”

Section: Discussionmentioning

confidence: 65%

Influenza H1N1 virus-associated pneumonia often resembles rapidly progressive interstitial lung disease seen in collagen vascular diseases and COVID-19 pneumonia; CT-pathologic correlation in 24 patients

Murota

Johkoh

Lee

et al. 2020

European Journal of Radiology Open

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Influenza H1N1 virus-associated pneumonia often resembles rapidly progressive interstitial lung disease seen in collagen vascular diseases and COVID-19 pneumonia; CT-pathologic correlation in 24 patients Makiko Murota (Supervision) (Methodology) (Writing-original draft), Takeshi Johkoh (Conceptualization) (Methodology) (Resources) (Writing-review and editing), Kyung Soo Lee (Resources) (Investigation), Tomas Franquet (Resources) (Investigation), Yasuhiro Kondoh (Resources) (Investigation), Yoshihiro Nishiyama (Writing-review and editing), Tomonori Tanaka (Investigation), Hiromitsu Sumikawa (Investigation), Ryoko Egashira (Writing-review and editing), Norihiko Yamaguchi (Resources) (Investigation), Kiminori Fujimoto (Writing-review and editing), Junya Fukuoka (Writing-review and editing), on behalf of the Group of Creation of Radiological Paper from Japan in diffuse lung disease

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“…Our patient was asymptomatic until April 2015; her symptoms had an acute onset resembling typical flu. Furthermore, clinical evidence suggests that the majority of the patients experience symptoms for less than two months [10][11][12]. However, in some patients, symptoms can persist.…”

Section: Discussionmentioning

confidence: 99%

A Case of Dermatomyositis Causing Cryptogenic Organizing Pneumonia

Miskoff

Ali

Chaudhri³

2019

Cureus

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Cryptogenic organizing pneumonia (COP), also known as idiopathic bronchiolitis obliterans organizing pneumonia (BOOP), is a rare inflammatory condition. It often presents as sequelae of existing chronic inflammatory diseases such as rheumatoid arthritis, systemic lupus erythematosus, and various connective tissue conditions. This case describes a 28-year-old African American female who presented with a complex clinical picture involving chronic inflammatory processes and the pulmonary system. The initial evaluation suggested pneumonia to be the underlying cause of respiratory symptoms; however, ultimately, a diagnosis of BOOP with dermatomyositis was made.

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A Cryptogenic Case of Fulminant Fibrosing Organizing Pneumonia

Cited by 8 publications

References 23 publications

Progression to fibrosing diffuse alveolar damage in a series of 30 minimally invasive autopsies with COVID‐19 pneumonia in Wuhan, China

Progression to fibrosing diffuse alveolar damage in a series of 30 minimally invasive autopsies with COVID‐19 pneumonia in Wuhan, China

Influenza H1N1 virus-associated pneumonia often resembles rapidly progressive interstitial lung disease seen in collagen vascular diseases and COVID-19 pneumonia; CT-pathologic correlation in 24 patients

A Case of Dermatomyositis Causing Cryptogenic Organizing Pneumonia

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