Cryptogenic organizing pneumonia associated with invasive pulmonary aspergillosis: a case report and review of the literature

International Journal of Clinical and Experimental Pathology

Haiyan Lin¹  Xiaolian Song¹  Lei Xu¹  Qing Yuan¹  Min Tan¹  Shuanshuan Xie¹  Kun Lu¹  Changhui Wang¹  Changxing Shen¹  Yunfeng Zhang¹  Feng Hu¹ 

关键词: Cryptogenic organizing pneumonia;    invasive pulmonary aspergillosis;    bronchiolitis obliterans organizing pneumonia;   

DOI  :  

学科分类：生理学与病理学

来源: e-Century Publishing Corporation

【 摘 要 】

Background: Concomitant occurrence of invasive pulmonary aspergillosis (IPA) with cryptogenic organizing pneumonia (COP) is scarce. Here, we report a case where COP was a presenting feature in a patient with diagnosed IPA, and review additional 58 COP patients reported in the literature from 1988 through 2013. Case outline: The study was reviewed and approved by the Institutional Ethics Committee of Shanghai Tenth People’s Hospital of Tongji University and was conducted in compliance with the Helsinki Declaration. Written informed consent was obtained from patient. A 56-year-old man presenting with productive cough for several weeks and unremitting high fever for a week was hospitalized with an initial clinical diagnosis of pneumonia, for which antibiotics were prescribed but did not work. Seeing that the condition progressed both clinically and radiographically, bronchoscopy, bronchoalveolar lavage and lung biopsy were performed, and the diagnosis of cryptogenic organizing pneumonia (COP) and invasive pulmonary aspergillosis (IPA) co-existence was made. Initially, the patient responded to steroid pulse therapy and voriconazole treatment, and his condition was partially improved. However, the patient’s condition deteriorated progressively 5 months after the disease onset and the patient died during the third admission due to respiratory failure and the adverse reactions of coriaceous hormone therapy. Conclusion: The diagnosis of cryptogenic organizing pneumonia (COP) and invasive pulmonary aspergillosis (IPA) co-occurrence depends on clinical, radiological and histological presentations. Similarities with other disease processes could lead to a delayed diagnosis or misdiagnosis. The present case suggests that clinicians should be alert to this disease in their clinical practices.

【 授权许可】

Unknown