Cryptogenic organising pneumonia presenting with bilateral hilar and mediastinal lymphadenopathy

Kahraman, Hasan; Tokur, Mahmut; Sayar, Hamide; İnci, Mehmet Fatih

doi:10.1136/bcr-2013-009712

Cited by 7 publications

(5 citation statements)

References 8 publications

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“…First, COP seldom presents with swollen hilar and mediastinal lymph nodes. The current literature showed that there were only two cases of patients with organizing pneumonia associated with hilar and mediastinal lymph nodes [14,15]. Second, most COP patients respond to glucocorticoid therapy well.…”

Section: Discussionmentioning

confidence: 99%

Organizing pneumonia secondary to lung cancer of unknown primary site

Mao

Zhang

Hou

et al. 2019

Respiratory Medicine Case Reports

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Background Secondary organizing pneumonia (OP) is associated with other pathological conditions, such as infections, drugs, cancers and radiotherapy. Lung cancer-associated secondary OP has rarely been reported. Case review In this study, we reported on a case of secondary OP caused by lung cancer. The patient was initially diagnosed with community-acquired pneumonia and then cryptogenic organizing pneumonia by CT scan-guided and transbronchial lung biopsy. Poor response to anti-infection or corticosteroid therapy prompted us to search for underlying disease. A TBNA biopsy of the 4R mediastinal lymph node revealed the diagnosis of lung cancer. Conclusion OP secondary to lung cancer of unknown primary site are rare. When OP patients have lymphadenopathy or poor response to glucocorticoid, a more differential diagnosis should be considered, especially for avoiding the misdiagnosis of a malignancy.

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Section: Discussionmentioning

confidence: 99%

Organizing pneumonia secondary to lung cancer of unknown primary site

Mao

Zhang

Hou

et al. 2019

Respiratory Medicine Case Reports

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“…Distinguishing cryptogenic organizing pneumonia from sarcoidosis can be difficult. Cryptogenic organizing pneumonia frequently occurs in 40 to 60 years, and sarcoidosis usually occurs in the age group of 20 to 50 [ 5 ]. Both entities may present with almost same clinical symptoms.…”

Section: Discussionmentioning

confidence: 99%

Cryptogenic Organizing Pneumonia with Sarcoidosis Overlap: An Atypical Case Study

Neelambra

Acharya

Sundararajan

2018

Case Reports in Medicine

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Case Summary We present a case of a young female with subacute symptoms of cough and progressive dyspnoea. On evaluation, the patient was diagnosed as cryptogenic organizing pneumonia based on her histopathological reports. However, her significant elevation of serum angiotensin-converting enzyme (SACE) levels which drop after treatment with oral steroids, relapse, and clinical presentation pointed towards sarcoidosis as clinical diagnosis. Discussion Here, in this patient, transbronchial biopsy was suggestive of cryptogenic organizing pneumonia along with chest X-ray, and the HRCT finding was also favouring the same. But in this case, we have also seen elevated levels of serum ACE which dropped significantly to the normal level along with a complete clearance of lesions with systemic steroids, and this favours sarcoidosis. Also, the recurrence was in different areas of the lung, and lesions once again responded both clinically and radiologically to steroids with a consistent drop in serum angiotensin-converting enzyme (SACE) levels, which again is a feature common in sarcoidosis. In COP, often complete clearance of the lesions is seldom seen, even though they do respond to steroids but not as dramatically as in our case. Also, recurrence of the lesion with BOOP at different sites is uncommon as it generally progresses in the same site. Conclusion This case report suggests that sarcoidosis as a possible cause of cryptogenic organizing pneumonia is worth considering with the mixed spectrum of presentation as in our case. And to our knowledge, this type of presentation of cryptogenic organizing pneumonia with sarcoidosis as an overlap disease is very rare, and this possibility needs to be explored by more series of such cases.

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“…[ 12 ], mild mediastinal lymph node enlargement was present in ∼20% of the patients. To our knowledge, three previous cases of OP presenting with extensive lymphadenopathy have been reported in literature [ 13 – 15 ].…”

Section: Discussionmentioning

confidence: 99%

An unusual presentation of a more common disease entity

Kerkhove

Wever

Verbeken

et al. 2018

Breathe

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A 66-year-old, male patient with a 10-pack-year history of smoking was referred to the internal medicine consultation because of a 4-week history of fatigue, weakness, intermittent low-grade fever, appetite and weight loss, and a mild dry cough. His previous history was unremarkable and his physical examination was normal. Routine laboratory screening revealed leukocytosis (11.08×109 leukocytes per L), elevated C-reactive protein (72.1 mg⋅L−1) and erythrocyte sedimentation rate 57 mm⋅h−1. Analyses for rheumatoid factor, antinuclear antibodies, and cytoplasmic and perinuclear anti-neutrophil cytoplasmic antibodies were all negative. Pulmonary function tests (static and dynamic volumes, flow–volume curve, and lung diffusion capacity) were within the predictive values. Chest radiography demonstrated bilateral hilar enlargement. The patient subsequently underwent a computed tomography (CT) scan of the chest (figure 1).

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Cryptogenic organising pneumonia presenting with bilateral hilar and mediastinal lymphadenopathy

Cited by 7 publications

References 8 publications

Organizing pneumonia secondary to lung cancer of unknown primary site

Organizing pneumonia secondary to lung cancer of unknown primary site

Cryptogenic Organizing Pneumonia with Sarcoidosis Overlap: An Atypical Case Study

An unusual presentation of a more common disease entity

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