[Behçet's disease with acute inflammatory foci and localized secondary organizing pneumonia]

A 68-year-old man with incomplete-type Behçet's disease was admitted to our hospital with a one-month history of a high fever and a persistent pulmonary infiltration shadow in the left lower lobe. Chest CT films showed localized round air-space consolidation in the left lower lobe. The fever did not responded to antibiotics, but did resolve with administration of prednisolone 15 mg/day. Left lower lobectomy was done to avoid life-threatening hemoptysis. Histological examination of the main pulmonary lesions revealed old vascular changes such as irregular intimal thickening and perivascular fibrosis. Disoriented elastic fibers of arteries was seen in some areas as were acute inflammatory foci with neutrophilic infiltration, and secondary organizing pneumonia with Masson bodies. From these findings Beçet's disease related pulmonary involvement could not be excluded. Localized secondary organizing pneumonia associated with acute inflammatory foci, as found in this case, is a very rare pulmonary manifestation of Behçet's disease.