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Weekly Chest CasesArchive of Old Cases

Case No : 557 Date 2008-06-30

  • Courtesy of Eun Ho Jang, MD, Joo Sung Sun, MD, Kyung Joo Park, MD. / Ajou University Hospital, Suwon, Korea
  • Age/Sex 47 / M
  • Chief ComplaintCough and arthralgia for 2 months
  • Figure 1
  • Figure 2
  • Figure 3

Diagnosis With Brief Discussion

Diagnosis
Bronchiolitis Obliterans Organizing Pneumonia (BOOP)
Radiologic Findings
Chest CT scan shows multiple ,fuzzy marginated nodules in both lungs. Some are represented as ground glass opacity or well defined nodule.
Brief Review
The organizing pneumonia pattern is often secondary to a known cause such as rheumatoid arthritis, viral pneumonia or drug reactions.

Most common chest radiograph shows bilateral or unilateral areas of patchy consolidation.

CT scan shows consolidation and ground-glass opacity with mild bronchial dilatation seen in regions of consolidation.

The distribution of COP is commonly involved subpleural or peribronchial area.

Differential diagnosis of CT findings includes alveolar cell carcinoma, lymphoma, vasculitis, sarcoidosis, and infection. When the consolidation is subpleural, chronic eosinophilic pneumonia should also be considered.
Please refer to
Case 63, Case 110, Case 286,
References
1. Conrad Wittram, MB ChB Eugene J. Mark, MD Theresa C. McLoud, MD:CT-Histologic Correlation of the ATS/ERS 2002 Classification of Idiopathic Interstitial Pneumonias:RadioGraphics 2003; 23:1057?071
2. Christina Mueller-Mang, MD Claudia Grosse et al: What Every Radiologist Should Know about Idiopathic Interstitial Pneumonias; RadioGraphics 2007:27:595?15
Keywords
Lung, Idiopathic interstitial pneumonia, COP, IIP,

No. of Applicants : 73

▶ Correct Answer : 13/73,  17.8%
  • - Shiga University of Medical Science , Japan Norihisa Nitta
  • - Osaka University , Japan Osamu Honda
  • - The Armed Forces HamPyeong Hospital , Korea (South) Bae Geun Oh
  • - CHU de Bordeaux , France Franis Laurent
  • - mediciti hospitals , India paramjyothi gongati
  • - nirman hitech diagnostic centre , India minal seth
  • - Soon chun hyang university hospital bucheon , Korea (South) Hyelin Kim
  • - Naval Education & Traning Command , Korea (South) Young Choi
  • - Gimpo Woori Hospital , Korea (South) Son Youl Lee
  • - Regional Imaging Ltd. - Riverina, NSW, Australia , Australia Rashid Hashmi
  • - Hospital Sotiria, Athens, Greece , Greece Vasilios Tzilas
  • - Apollo Hospital, Ahmedabad. , India Sandip Shah.
  • - Armed Forces Chun-Cheon Hospital , Korea (South) ChaeHun Lim
▶ Correct Answer as Differential Diagnosis : 15/73,  20.5%
  • - EKH-Berlin , Germany Michael Weber
  • - BOLLINENI HOSPITAL NELLORE , India jignesh dubal
  • - Kashan University of Medical Sciences, kashan, Iran , Iran Ebrahim Razi
  • - Hanmaeum Hospital , Korea (South) Kwon Kim
  • - Central Queensland Medical Imaging , Australia Sandeep Joshi
  • - E-DA Hospital / I-Shou University , Taiwan Yu-Feng Wei
  • - Samsung Medical Center , Korea (South) Dae Kun Oh
  • - clinique de SAVOIE , France, Metropolitan gay-depassier philippe
  • - Samsung Medical Center , Korea (South) Kim Young
  • - Dongguk University International Hospital , Korea (South) Hee Seok Choi
  • - Depatment of Radiology, Yongsan Hospital, College of Medicine, Chung-Ang University , Korea (South) Jae Seung Seo
  • - Vital Imaging Centre, Mumbai,India , India Ganesh Agrawal
  • - Seoul National University Hospital , Korea (South) Sang Min Lee
  • - All India Institute of medical sciences , India Justin Moses
  • - Jackson Memorial Hospital , United States Naganathan Mani
▶ Semi-Correct Answer : 44/73,  60.3%
  • - McGill University Health Centre , Canada Amr Ajlan
  • - China Medical University,Taiwan,R.O.C. , Taiwan Jun Jun Yeh
  • - Chungnam National University hospital , Korea (South) Kyoung Jin Oh
  • - Marien Hospital, Hamm , Germany Davis Chiramel
  • - CHRU lille , France manuel toledano
  • - brm hospital , India chemmandi sudhan
  • - Ondokuz Mayis University , Turkey Cetin Celenk
  • - Trakya Univercity School of Medicine , Turkey Armagan Sarac
  • - HOSPITAL SOTIRIA , Greece AIKATERINI DELAVERI
  • - MD PG Resident, PIMS,LONI, MAHARASHTRA, INDIA , India Sushant Bhadane
  • - Louisiana State University - Shreveport , United States Carlos Previgliano
  • - Deptt of Radiodiagnosis & Imaging, PGIMER chandigarh , India Ram Galwa
  • - jaslok hospital mumbai , India jainendra jain
  • - partner, aditya imaging centre , India vivek patel
  • - Kasturba Medical College Manipal , India Paresh Desai
  • - Dongguk University International Hospital , Korea (South) Ah-young Kim
  • - Seoul National University Hospital , Korea (South) Chang Min Park
  • - CATHAY GENERAL HOSPITAL, SIJHIH , Taiwan CHIH-HUNG LIN
  • - Soonchunhyang university Bucheon hospital , Korea (South) Minhee Lee
  • - McGill University Health Center , Canada Alexandre Semionov
  • - kims,narkatpally , India k bhaskar
  • - hospital Sao Paulo , Brazil israel missrie
  • - Changhua Christian Hospital , Taiwan Chia-Fu Tsai
  • - Mackay Memorial Hospital , Taiwan Shen ShengYeh
  • - BHMRC , India nidhi goyal
  • - radiology department ANNECY , France gilles GENIN
  • - Trakya University School of Medicine , Turkey Derya Demir
  • - EWHA WOMANS MOKDONG UNIVERSITY HOSPITAL , Korea (South) YOOKYUNG KIM
  • - Yonsei University college of medicine Severance hospital , Korea (South) Hua Sun Kim
  • - Hangang Sacred Heart Hospital , Korea (South) Eil Seong Lee
  • - Soonchunhyang University Cheonan Hospital , Korea (South) Park Sang Hyun
  • - PITTWATER RADIOLOGY , Australia Julie Arora
  • - PITTWATER RADIOLOGY , Australia Saurabh Khandelwal
  • - Deenanath Mangeshkar Hospital, Pune , India Anubhav Khandelwal
  • - chp st martin , France Mariotte benoit
  • - Assam medical college, INDIA , India karunakaran M
  • - Pe d , France Fabrice Bing
  • - Father Muller Medical College , Mangalore , India nabil mahmood
  • - Homs National Hospital , Syria Rami Abou Zalaf
  • - Medical College Chest Hospital,Thrissur,Kerala , India Raveendran TK
  • - All India Institute of Medical Sciences , India puneet kochar
  • - All India Institute of Medical Sciences , India Ashish Gupta
  • - Trakya University School of Medicine , Turkey Umut Ugur
  • - Hopital universitaire Lausanne , Switzerland abed kourhani
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