Diagnostic procedures and clinico-radiological findings of acute fibrinous and organizing pneumonia: a systematic review and pooled analysis

Lee, Jong Hyuk; Yum, Ho Kee; Jamous, Fady; Santos, Cid Aimbiré de Moraes; Campisi, Alessio; Surani, Salim; Lococo, Filippo; Goo, Jin Mo; Yoon, Soon Ho

doi:10.1007/s00330-021-07868-z

Cited by 8 publications

(9 citation statements)

References 63 publications

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“…AFOP is considered a histological pattern in the clinical spectrum of diffuse alveolar damage and organizing pneumonia. Patchy or mass-like consolidation is the most common pattern of AFOP and appears to have a better prognosis ( 2 ). In addition to consolidation and nodules, CT findings of AFOP could also present as ground-glass opacity and reticular or linear opacity.…”

Section: Discussionmentioning

confidence: 99%

“…Patchy or mass-like consolidation is the most common pattern in computed tomography (CT) findings. However, radiological findings could also be followed by ground glass opacity, reticular and linear opacities, and nodules ( 2 ). The prognosis of AFOP appears to have two distinct patterns: (i) an acute and unresponsive course that always leads to respiratory failure with rapid progression to death and (ii) a subacute, mild, and responsive course with recovery ( 3 ).…”

Section: Introductionmentioning

confidence: 99%

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Case report: Corticosteroid-resistant acute fibrinous and organizing pneumonia with myelodysplastic syndrome

Jiang

Chen

et al. 2023

Front. Med.

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Acute fibrinous and organizing pneumonia (AFOP) is a lung disease with an unusual pathological pattern. The definitive diagnosis of AFOP relies on pathological evidence of intra-alveolar fibrin exudate, lymphoplasmacytic infiltrate, and the absence of a hyaline membrane. Furthermore, its etiology is difficult to confirm, and corticosteroids are usually effective. Herein, we report the case of a young male who presented with high fever, hemocytopenia, and consolidation in both lungs. The initial misdiagnosis was community-acquired pneumonia. Subsequently, a lung biopsy revealed abundant fibrin and fibroblast exudates in the alveolar spaces, indicating AFOP. In addition, bone marrow biopsy and karyotype analysis demonstrated that the patient simultaneously had myelodysplastic syndrome (MDS) and hemophagocytic lymphohistiocytosis. In this case, the AFOP was considered secondary to MDS; however, the disease did not respond to glucocorticoid treatment or chemotherapy. Hence, AFOP should be considered in patients with underlying hematological diseases, and early identification and diagnosis are important. Furthermore, the management of patients with severe AFOP requires further investigation.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Case report: Corticosteroid-resistant acute fibrinous and organizing pneumonia with myelodysplastic syndrome

Jiang

Chen

et al. 2023

Front. Med.

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“…CIOP is a rare histological variant of OP, which has been referred to by various names, including fibrosing OP, collagenized OP, and scarring variant of OP; these names should be consolidated to a single term ( 16 , 25 , 81–83 ). Yousem et al found this variant in histological specimens from 12 of 223 patients with OP, which had been collected over a 20-year period.…”

Section: Variants Of Organizing Pneumoniamentioning

confidence: 99%

Update on cryptogenic organizing pneumonia

Radzikowska¹,

Fijołek²

2023

Front. Med.

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Cryptogenic organizing pneumonia (COP) is a form of idiopathic interstitial pneumonia that results from the pulmonary reaction to various unidentified injuries. Secondary organizing pneumonia is diagnosed when the triggering factor has been identified; it is mainly caused by infections, toxic substance exposure, drugs, connective tissue diseases, malignancies, autoimmune diseases, bone marrow, or organ transplantation, and radiotherapy. There has been an increase in the number of reports of drug-induced organizing pneumonia (OP). New biological therapies, interferon, monoclonal antibodies, anti-interleukin antibodies, and PD1/PDL-1 inhibitors may induce this specific pulmonary reaction. The classical form of COP is usually subacute and does not manifest as severe disease. Patients maintain sufficient respiratory function, and treatment with steroids is usually effective. Several specific forms of OP (e.g., the cicatricial variant or acute fibrinous type) have distinct clinical and histological features, require higher doses of immunosuppressive drugs, and have a worse prognosis. In the era of administering steroid-sparing therapies for the treatment of interstitial lung diseases, connective tissue dases, and other conditions, it is important to emphasize this type of therapy for patients with COP.

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“…AFOP is considered a composite of diffuse alveolar damage, cryptogenic organizing pneumonia, and eosinophilic pneumonia ( 2 ), and is classified into acute and subacute types. Its occurrence is rare, mainly reported in the US and China ( 3 - 6 ). The dominant symptoms are respiratory insufficiency, cough, and fever.…”

Section: Introductionmentioning

confidence: 99%

“…The dominant symptoms are respiratory insufficiency, cough, and fever. AFOP is related to an idiopathic cause or autoimmune disease, drug use, infection, cancer, or transplantation ( 6 ). Existing data did not report the correlation between AFOP and demographics.…”

Section: Introductionmentioning

confidence: 99%

Lesson of urgent bilateral lobar lung transplantation for acute fibrinous and organizing pneumonia: a case report

Ye,

Chen,

Huang

et al. 2023

AME Case Rep

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Background Acute fibrinous and organizing pneumonia (AFOP) is one of acute expiratory diseases, which occurs rarely with a difficult diagnosis. AFOP is related to an idiopathic cause or autoimmune disease, drug use, infection, cancer, or transplantation. Variation of treatment depends on different institutions. To date, no evidence shows that lobar lung transplantation is applied in an urgent situation such as AFOP. Case Description A 33-year-old female patient experienced fever, cough, and dyspnea four days prior to admission. She had no underlying health conditions. Initially, she received oxygen therapy and empiric antimicrobial treatment, but later developed pulmonary consolidation. Pathological examination confirmed the diagnosis of AFOP. Despite receiving standardized treatment involving extracorporeal membrane oxygenation (ECMO) and mechanical ventilation, the patient’s respiratory function remained compromised. Consequently, an urgent lobar lung transplantation was performed. However, the patient encountered several challenges including carbapenem-resistant Pseudomonas aeruginosa pneumonia, exophytic granulation tissue, anastomotic stenosis, bronchopleural fistulae, anastomotic infections, septic shock, bacteremia, reperfusion syndrome, primary graft dysfunction, severe renal failure, and critical illness myopathy. Although the patient ultimately recovered and had a favorable survival outcome over 1-year post-discharge through multidisciplinary care, there are several key points to consider. Based on the findings from a systematic review, urgent transplantation may be a potential alternative treatment for AFOP. However, peri-transplantation programs should be enhanced, particularly regarding criteria selection, ECMO management, and the role of enhanced recovery after transplantation. Conclusions The case demonstrates the feasibility of bilateral lobar lung transplantation in patients with AFOP, especially in an urgent situation.

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Diagnostic procedures and clinico-radiological findings of acute fibrinous and organizing pneumonia: a systematic review and pooled analysis

Cited by 8 publications

References 63 publications

Case report: Corticosteroid-resistant acute fibrinous and organizing pneumonia with myelodysplastic syndrome

Case report: Corticosteroid-resistant acute fibrinous and organizing pneumonia with myelodysplastic syndrome

Update on cryptogenic organizing pneumonia

Lesson of urgent bilateral lobar lung transplantation for acute fibrinous and organizing pneumonia: a case report

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