Cicatricial organising pneumonia mimicking a fibrosing interstitial pneumonia

Cicatricial organising pneumonia mimicking a fibrosing interstitial pneumonia IntroductionOrganising pneumonia (OP, also called bronchiolitis obliterans with organising pneumonia – BOOP, or cryptogenic organising pneumonia – COP) is characterised pathologically by loose granulation plugs in the lumens of respiratory bronchioles and alveolar ducts, and radiologically most often by areas of migratory peripheral consolidation or peribronchovascular consolidation on high‐resolution computerized tomography (CT) scan. OP is usually steroid‐responsive, with radiological disappearance of the opacities, although disease may recur on steroid cessation.OP, by definition, does not have interstitial fibrosis or dense fibrosis. Recently, Yousem described what he termed ‘cicatricial COP’, a picture in which the granulation tissue of OP fails to resolve and instead organises, with fibrous tissue replacing the granulation tissue.Cicatricial COP as described by Yousem still retains the architecture of OP without development of interstitial fibrosis. We have encountered a number of cases of OP in which there is not only organisation to dense fibrous tissue, but also formation of densely fibrotic linear bands or densely fibrotic small nodules in the lung parenchyma, so that the process does not look like OP at all, but suggests a diagnosis of a fibrosing interstitial pneumonia. Here we describe the pathological and radiological features of such cases.Materials and methodsCases were selected from http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Histopathology Wiley

Cicatricial organising pneumonia mimicking a fibrosing interstitial pneumonia

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Publisher
Wiley
Copyright
Copyright © 2018 John Wiley & Sons Ltd
ISSN
0309-0167
eISSN
1365-2559
D.O.I.
10.1111/his.13443
Publisher site
See Article on Publisher Site

Abstract

IntroductionOrganising pneumonia (OP, also called bronchiolitis obliterans with organising pneumonia – BOOP, or cryptogenic organising pneumonia – COP) is characterised pathologically by loose granulation plugs in the lumens of respiratory bronchioles and alveolar ducts, and radiologically most often by areas of migratory peripheral consolidation or peribronchovascular consolidation on high‐resolution computerized tomography (CT) scan. OP is usually steroid‐responsive, with radiological disappearance of the opacities, although disease may recur on steroid cessation.OP, by definition, does not have interstitial fibrosis or dense fibrosis. Recently, Yousem described what he termed ‘cicatricial COP’, a picture in which the granulation tissue of OP fails to resolve and instead organises, with fibrous tissue replacing the granulation tissue.Cicatricial COP as described by Yousem still retains the architecture of OP without development of interstitial fibrosis. We have encountered a number of cases of OP in which there is not only organisation to dense fibrous tissue, but also formation of densely fibrotic linear bands or densely fibrotic small nodules in the lung parenchyma, so that the process does not look like OP at all, but suggests a diagnosis of a fibrosing interstitial pneumonia. Here we describe the pathological and radiological features of such cases.Materials and methodsCases were selected from

Journal

HistopathologyWiley

Published: Jan 1, 2018

Keywords: ; ; ; ;

References

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