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Published on: December 19, 2020
Rapidly progressive cryptogenic organising pneumonia presenting as a lung mass
Saeed Akram1, Muhammad Irfan, Kanwal Aftab
1Pulmonary Medicine, Aga Khan University Hospital Pakistan, Karachi, 75950, Pakistan.
BMJ Case Reports
|June 21, 2011
Summary
A rare, rapidly progressive cryptogenic organizing pneumonia (COP) mimicked a lung mass, causing airway compression and respiratory failure. Prompt steroid treatment led to complete resolution, highlighting COP
Area of Science:
- Pulmonology
- Thoracic Surgery
- Pathology
Background:
- Cryptogenic organizing pneumonia (COP) is an idiopathic interstitial pneumonia.
- COP can present atypically, mimicking other lung pathologies like malignancy.
- Rapidly progressive forms of COP can lead to acute respiratory failure.
Purpose of the Study:
- To describe a rare case of rapidly progressive COP presenting as a focal mass-like lesion.
- To highlight the diagnostic challenges and management of this COP variant.
- To emphasize the importance of considering COP in the differential diagnosis of lung masses.
Main Methods:
- Case report of a 60-year-old female presenting with hypoxemic respiratory failure.
- Diagnostic workup included chest X-ray, CT-guided lung biopsy, pleural fluid analysis, and bronchoscopy.
- Definitive diagnosis of COP was established via video-assisted thoracoscopic (VATS) lung biopsy.
Main Results:
- The patient presented with a right upper lobe mass-like lesion causing significant airway compression.
- Initial investigations for infection and malignancy were negative.
- VATS biopsy confirmed COP, and the patient responded well to high-dose steroid therapy, showing complete radiological resolution at 3-month follow-up.
Conclusions:
- Rapidly progressive COP can present as a focal mass, posing a diagnostic challenge.
- Early diagnosis and prompt treatment with corticosteroids are crucial for favorable outcomes.
- This case underscores the importance of considering COP in the differential diagnosis of obstructive lung lesions.
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