Difference between revisions of "Organizing pneumonia"

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

Latest revision as of 16:55, 6 April 2016

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]

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.^[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:

Diffuse alveolar damage, proliferative phase - has type 2 pneumoncyte hyperplasia.
Bronchiolitis obliterans.

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:

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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.

References

↑ ^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.
↑ Klatt, Edward C. (2006). Robbins and Cotran Atlas of Pathology (1st ed.). Saunders. pp. 110. ISBN 978-1416002741.

[Ref_WMSP91-1] 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.

[Ref_Klatt110-2] Klatt, Edward C. (2006). Robbins and Cotran Atlas of Pathology (1st ed.). Saunders. pp. 110. ISBN 978-1416002741.

[1]

[2]

@@ Line 1: / Line 1: @@
+{{ 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]].
@@ Line 11: / Line 42: @@
 *Toxic injury.
 *Infection.
-*Peri-tumor - in proximity to a space-occupying lesion (abscess, neoplasm).
+*Peri-tumour - in proximity to a space-occupying lesion (abscess, neoplasm).
 Note:
@@ Line 30: / Line 61: @@
 ===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://150.59.224.157/pathology/system/data/image_data/11338411170518.jpg Masson body (150.59.224.157)].<ref>URL: [http://150.59.224.157/pathology/index.php?first_category_id=2&second_category_id=20 http://150.59.224.157/pathology/index.php?first_category_id=2&second_category_id=20]. Accessed on: 4 August 2011.</ref>
 *[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==

Difference between revisions of "Organizing pneumonia"

Latest revision as of 16:55, 6 April 2016

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