Difference between revisions of "Organizing pneumonia"

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#redirect [[Diffuse_lung_diseases#Organizing_pneumonia]]
{{ Infobox diagnosis
| Name      = {{PAGENAME}}
| Image      = Organizing pneumonia -- low mag.jpg
| Width      =
| Caption    = Organizing pneumonia. [[H&E stain]].
| Synonyms  =
| Micro      = distal airway disease -- airways plugged with organizing exudate (fluffy light-staining paucicellular regions with stellate cells); no hobnailing of pneumocytes; type 2 pneumocytes hyperplasia is absent
| Subtypes  =
| LMDDx      = [[diffuse alveolar damage]] (proliferative phase), [[bronchiolitis obliterans]].
| Stains    =
| IHC        =
| EM        =
| Molecular  =
| IF        =
| Gross      =
| Grossing  =
| Site      = [[lung]] - ''[[diffuse lung diseases]]''
| Assdx      =
| Syndromes  =
| Clinicalhx =
| Signs      =
| Symptoms  =
| Prevalence = uncommon
| Bloodwork  =
| Rads      =
| Endoscopy  =
| Prognosis  = dependent on underlying cause
| Other      =
| ClinDDx    = [[cryptogenic organizing pneumonia]], [[lung transplant pathology|transplant rejection]], infection  ([[pneumonia]]), [[collagen vascular disease]], peri-tumour
| Tx        = dependent on underlying cause
}}
'''Organizing pneumonia''', abbreviated '''OP''', is a histologic pattern in [[lung pathology]]. It fits into the larger category of [[diffuse lung diseases]].
 
==General==
*Multiple causes, e.g. transplant rejection, infection.
 
Clinical diagnoses:<ref name=Ref_WMSP91>{{Ref WMSP|91}}</ref>
*[[Lung transplant pathology|Transplant rejection]].
*Cryptogenic organizing pneumonia (COP), [[AKA]] (idiopathic) bronchiolitis obliterans organizing pneumonia (BOOP).
**Should '''not''' be confused with ''[[constrictive bronchiolitis]]'' (AKA ''[[bronchiolitis obliterans]]'').
*[[Collagen vascular disease]].
*Toxic injury.
*Infection.
*Peri-tumour - in proximity to a space-occupying lesion (abscess, neoplasm).
 
Note:
*BOOP is used as a synonym for ''organizing pneumonia'' which has the long differential diagnosis above.<ref name=Ref_WMSP91>{{Ref WMSP|91}}</ref>
**Confusingly, it may be used to refer to the idiopathic form of organizing pneumonia, now generally known as ''cryptogenic organizing pneumonia'' (COP).
***In other words, strictly speaking, ''BOOP'' is '''not''' the same as ''COP''; idiopathic BOOP ''is'' COP.
 
==Microscopic==
Features:<ref name=Ref_Klatt110>{{Ref Klatt|110}}</ref>
*Distal airway disease -- airways plugged with organizing exudate ("[[Masson bodies]]").
**"Organized exudate" = fluffy light-staining paucicellular regions with stellate cells (fibroblasts & immature connective tissue).
*'''No''' hobnailing of pneumocytes.
**Type 2 pneumocytes hyperplasia is absent.
 
DDx:
*[[Diffuse alveolar damage]], proliferative phase - has type 2 pneumoncyte hyperplasia.
*[[Bronchiolitis obliterans]].
 
===Images===
<gallery>
Image: Organizing pneumonia -- very low mag.jpg | OP - very low mag. (WC/Nephron)
Image: Organizing pneumonia -- low mag.jpg | OP - low mag. (WC/Nephron)
Image: Organizing pneumonia - alt -- low mag.jpg | OP - low mag. (WC/Nephron)
Image: Organizing pneumonia - alt - intermed mag.jpg | OP - intermed. mag. (WC/Nephron)
Image: Organizing pneumonia -- intermed mag.jpg | OP - intermed. mag. (WC/Nephron)
Image: Organizing pneumonia -- high mag.jpg | OP - high mag. (WC/Nephron)
</gallery>
===Masson body===
<gallery>
Image:Masson_body_-_intermed_mag.jpg | Masson body - intermed. mag. (WC/Nephron)
Image:Masson_body_-_high_mag.jpg | Masson body - high mag. (WC/Nephron)
Image:Masson_body_-_very_high_mag.jpg | Masson body - very high mag. (WC/Nephron)
</gallery>
www:
*[http://casereports.bmj.com/content/2011/bcr.11.2010.3483.full BOOP (bmj.com)].
*[http://www.flickr.com/photos/pulmonary_pathology/4733384977/ Masson body (flickr.com)].
*[https://www.flickr.com/photos/pulmonary_pathology/3734401023 Organizing pneumonia (flicker.com)].
 
==Sign out==
<pre>
Lung, Right Lower Lobe, Open Lung Biopsy:
- Organizing pneumonia.
- Emphysematous changes.
- NEGATIVE for significant pulmonary fibrosis.
- NEGATIVE for malignancy.
 
Comment:
There is no evidence of granulomatous disease.
</pre>
===Micro===
Organizing pneumonia with well-formed Masson bodies is seen subpleural and peribronchial. It is pathcy and mild. Significant fibrosis is absent. Eosinophils are not readily apparent.
 
==See also==
*[[Diffuse lung disease]].
*[[Pneumonia]].
 
==References==
{{Reflist|2}}


[[Category:Diagnosis]]
[[Category:Diagnosis]]
[[Category:Diffuse lung diseases]]

Latest revision as of 16:55, 6 April 2016

Organizing pneumonia
Diagnosis in short

Organizing pneumonia. H&E stain.
LM distal airway disease -- airways plugged with organizing exudate (fluffy light-staining paucicellular regions with stellate cells); no hobnailing of pneumocytes; type 2 pneumocytes hyperplasia is absent
LM DDx diffuse alveolar damage (proliferative phase), bronchiolitis obliterans.
Site lung - diffuse lung diseases
Prevalence uncommon
Prognosis dependent on underlying cause
Clin. DDx cryptogenic organizing pneumonia, transplant rejection, infection (pneumonia), collagen vascular disease, peri-tumour
Treatment dependent on underlying cause

Organizing pneumonia, abbreviated OP, is a histologic pattern in lung pathology. It fits into the larger category of diffuse lung diseases.

General

  • Multiple causes, e.g. transplant rejection, infection.

Clinical diagnoses:[1]

Note:

  • BOOP is used as a synonym for organizing pneumonia which has the long differential diagnosis above.[1]
    • Confusingly, it may be used to refer to the idiopathic form of organizing pneumonia, now generally known as cryptogenic organizing pneumonia (COP).
      • In other words, strictly speaking, BOOP is not the same as COP; idiopathic BOOP is COP.

Microscopic

Features:[2]

  • Distal airway disease -- airways plugged with organizing exudate ("Masson bodies").
    • "Organized exudate" = fluffy light-staining paucicellular regions with stellate cells (fibroblasts & immature connective tissue).
  • No hobnailing of pneumocytes.
    • Type 2 pneumocytes hyperplasia is absent.

DDx:

Images

  • OP - very low mag. (WC/Nephron)

  • OP - low mag. (WC/Nephron)

  • OP - low mag. (WC/Nephron)

  • OP - intermed. mag. (WC/Nephron)

  • OP - intermed. mag. (WC/Nephron)

  • OP - high mag. (WC/Nephron)

Masson body

  • Masson body - intermed. mag. (WC/Nephron)

  • Masson body - high mag. (WC/Nephron)

  • Masson body - very high mag. (WC/Nephron)

www:

Sign out

Lung, Right Lower Lobe, Open Lung Biopsy:
- Organizing pneumonia.
- Emphysematous changes.
- NEGATIVE for significant pulmonary fibrosis.
- NEGATIVE for malignancy. 

Comment:
There is no evidence of granulomatous disease.

Micro

Organizing pneumonia with well-formed Masson bodies is seen subpleural and peribronchial. It is pathcy and mild. Significant fibrosis is absent. Eosinophils are not readily apparent.

See also

References

  1. ↑ 1.0 1.1 Humphrey, Peter A; Dehner, Louis P; Pfeifer, John D (2008). The Washington Manual of Surgical Pathology (1st ed.). Lippincott Williams & Wilkins. pp. 91. ISBN 978-0781765275.
  2. ↑ Klatt, Edward C. (2006). Robbins and Cotran Atlas of Pathology (1st ed.). Saunders. pp. 110. ISBN 978-1416002741.
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