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Article in Japanese
Abstract
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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