Cryptogenic organizing pneumonia masquerading as lung carcinoma: A case report and review of the literature

Abstract

Cryptogenic organizing pneumonia (COP) is a rare pulmonary disorder of unknown etiology. COP with hemoptysis as the primary presenting symptom has rarely been reported. The present study reported a case of COP that resembled lung carcinoma with hemoptysis as the only clinical symptom. The patient recovered well following thoracoscope surgery. A literature review of 119 COP cases between 1995 and 2015 was presented. Cough, fever and dyspnea were the most common clinical manifestations. The most common imaging manifestations were multiple or single consolidation, lung nodules, migratory sign, reversed halo sign, and multiple ground-glass opacity. A total of 3 cases exhibited COP accompanied by lung cancer. Glucocorticoids were effective for the majority of cases and invasive surgeries were implemented in most cases. The majority of cases recovered or relieved, and the prognosis of COP was relatively good. COP was easily confused with lung tumor and it is necessary to make differential diagnosis between COP and lung cancer. Invasive surgery should be avoided when possible to avoid or reduce patient trauma.

ALK-positive lung adenocarcinoma in a patient with rheumatoid arthritis with long-term treatment for organizing pneumonia: A case report

“…[11] Corticosteroids were effective against OP masquerading as lung carcinoma. [9] ALK gene rearrangements are present in 3% to 5% non-small cell lung cancers, and generally found in younger patients who are nonsmokers. [12] However, a number of elderly-onset ALK mutations have been reported.…”

“…[ 8 ] Some cases have been reported to be complicated/coexist with lung cancer. [ 9 ] Therefore, lung cancer can represent a diagnostic challenge, especially in patients with underlying pulmonary diseases including OP.…”

Acute Fibrinous and Organizing Pneumonia Case Report and Review: Distinguishing AFOP from Similar Organizing Pneumonias

“…A key histological pattern that distinguishes COP from AFOP is the fibrous plugs called Masson bodies. Masson bodies consist of fibroblasts and myofibroblasts in the alveoli, alveolar ducts, and terminal bronchioles [15], surrounded by pale-staining matrix [11]. Masson bodies may be accompanied by inflammatory cells, such as lymphocytes, plasma cells and macrophages [13].…”

“…Diffuse Alveolar Damage (DAD) is a reaction to wide range of factors including infection, drugs, toxic inhalation, or it can be idiopathic [11]. Treatment for DAD includes antibacterial therapy, corticosteroids, Intravenous Masson bodies 15 , pale-staining matrix [11], inflammatory cells [13], alveolar septae are not damaged, but may be slightly thickened with cellular infiltrate [13] Corticoteroids [12] BOS Cough, dyspnea, sputum production fever, hypoxia, and adventitious lung sounds…”

Aspects of Computed Tomography in Diagnostics of Organizing Pneumonia

“…В такой ситуации морфологический диагноз ОП обычно устанавливают после диагностической пункционной биопсии или выполнения хирургической операции по поводу предполагаемой опухоли. В недавних исследованиях [41,42], посвященных диагностике фокальной (узловой) формы организующей пневмонии и рака легкого было продемонстрировано, что даже ПЭТ-КТ не является информативным в таких случаях: показатель накопления 18F-ФДГ нельзя использовать в качестве инструмента для дифференциальной диагностики организующей пневмонии и периферического рака легкого. Исследование в динамике -единственный критерий, позволяющий с большой долей вероятности предположить правильный диагноз у таких пациентов, при невозможности морфологической верификации.…”