대한흉부영상의학회 Weekly Chest Cases

Courtesy of Joon Beom Seo, M.D., Jin Seong Lee, M.D., Koun-Sik Song, M.D. / Asan Medical Center, Seoul, Korea
Age/Sex 60 / M
Chief ComplaintDyspnea for several months

Diagnosis: Bronchiolitis Obliterans Organizing Pneumonia
Radiologic Findings: PA chest radiograph shows bilateral areas of consolidation, predominantly in lower lung zones. Thin-section CT scans show patchy areas of consolidation and ground-glass opacity in both lungs.Predominant lower lung zone, subpleural, peribronchial distribution of the lesions is noted.

Open lung biopsy revealed multipel granulation polyps filling respiratiory bronchioles and alveolar ducts and bronchial wall thickening, consistent with broncholitis obliterans organizing pneumonia.
Brief Review: Histology
Granulation tissue polyps within respiratory bronchioles and alveolar ducts (Masson bodies) associated with patchy orgainzing pneumonia

Symptom
nonproductive cough, low-grade fever, shortness of breath

CT findings
Major
Pathcy bilateral airspace consolidation (80%)
Ground-glass opacity (60%)
Subpleural and/or peribronchovascular distribution
Minor
Bronchial wall thickening, dilatation
Small nodular opacities
Large nodules
Pleural effusion
Honeycombing (uncommon)
References
Keywords

대한흉부영상의학회 Korean Society of Thoracic Radiology