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Abstract

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Article in Japanese

Case Report

An autopsy case of fibrotic nonspecific interstitial pneumonia exacerbated after pathological diagnosis as organizing pneumonia

Yuki Iijimaa  Yukihiko Sugiyamaa  Naoko Matoa  Hideaki Yamasawaa  Tamiko Takemurab  Masashi Bandoa 

aDivision of Pulmonary Medicine, Department of Medicine, Jichi Medical University
bDepartment of Pathology, Japanese Red Cross Medical Center

ABSTRACT

The patient was a 79-year-old man who 8 years ago had dyspnea on exertion and an abnormal lung shadow. He was diagnosed as cryptogenic organizing pneumonia (COP) by typical appearance of subpleural consolidation and pathological findings in transbronchial lung biopsy. Although he had shown typical process as COP, he died by acute exacerbation 8 years after diagnosis. Autopsy findings in the lungs showed fibrotic nonspecific interstitial pneumonia (f-NSIP) and diffuse alveolar damage. We can pathologically detect organizing pneumonia (OP) in many other diseases other than COP. Moreover, it is also reported that OP and f-NSIP may coexist in the same patient, and some patients diagnosed as COP show resistance to corticosteroid therapy and progression of fibrosis. Here we considered the difficulty in diagnosis and evaluation of the clinical course of OP in a bronchoscopy specimen from viewpoints of validity of the original diagnosis and etiology of the clinical course of fibrosis.

KEYWORDS

Cryptogenic organizing pneumonia  Nonspecific interstitial pneumonia  Idiopathic interstitial pneumonia  Pulmonary fibrosis 

Received 23 Jun 2015 / Accepted 7 Sep 2015

AJRS, 5(1): 18-22, 2016

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