Acute Fibrinous and Organizing Pneumonitis (AFOP) is a disease with histopathological pattern characterized by the presence of intra-alveolar fibrin in the form of fibrin "balls" and organizing pneumonia represented by inflammatory myofibroblastic polyps. Symptoms of this rare interstitial pulmonary disease can be either acute or sub-acute and it can rapidly progress to death. Diagnosis should be considered in the Intensive Care Unit (ICU) if patients' symptomatology and radiology correlates with non-responding or progressive pneumonia and when morphology, on biopsies, encompasses criteria of diffuse alveolar damage (DAD) and organizing pneumonia (OP) balancing in between. Three clinical cases of patients presenting severe lung disease requiring mechanical ventilation and prolonged intensive care fitted on the variable spectra of AFOP histopathology and had poor outcome: a 23 year-old women had AFOP in the context of antiphospholipid syndrome pulmonary compromise; a 35 year-old man developed a letal intensive care pneumonia with AFOP pattern registered in post-mortem biopsy; and a 79 year-old man died 21 days after intensive care unit treatment of a sub-pleural organizing pneumonia with intra-alveolar fibrin, seen in post-mortem biopsy. The predominance of acute fibrin alveolar deposition pattern is helpful in raising AFOP differential diagnosis while organizing pneumonia pattern establishes a wider range of diagnosis that can go till solitary pulmonary nodule, remaining indefinite to suggest diagnosis. The performance time of biopsy in a larger number of clinical cases may be helpful in establishing the evolutionary morphological pattern, taking in mind the poor outcome of the disease, deserving rapid diagnosis to define treatment.
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http://dx.doi.org/10.1016/j.pathophys.2019.04.001 | DOI Listing |
Ann Indian Acad Neurol
January 2025
Digestive System Service, Ourense University Hospital Complex, Ourense, Spain.
J Community Hosp Intern Med Perspect
January 2025
MedStar Health Franklin Square Medical Center, Baltimore, MD, USA.
Acta Radiol
January 2025
PET-CT Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shannxi, PR China.
Background: Computed tomography (CT) is the most common way to evaluate focal organizing pneumonia (FOP); however, sometimes it is difficult to differentiate FOP and peripheral lung carcinoma (PLC).
Purpose: To clarify the MRI manifestation of FOP and the value of MR in the differential diagnosis of FOP and PLC in comparison to CT.
Material And Methods: Chest MR (3D T1WI, T2WI TSE, DWI) and CT images of 72 patients (50 men: mean age=64.
J Clin Med
January 2025
Department of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan.
Lung malignancies, including cancerous lymphangitis and lymphomas, can mimic interstitial lung diseases like cryptogenic organizing pneumonia (COP) on imaging, leading to diagnostic delays. We aimed to identify potential biomarkers to distinguish between these conditions. We analyzed bronchoalveolar lavage fluid from 8 patients (4 COP, mean age 59.
View Article and Find Full Text PDFBMJ Case Rep
January 2025
Pneumology, Centre Hospitalier du Valais Romand, Sion, Switzerland.
A woman in her mid-70s presented with worsening dyspnoea, cough and fatigue initially treated for pneumonia. Despite antibiotics, her condition deteriorated, prompting further investigation. Medical history included previous breast implants, the latter of which had ruptured years earlier and was subsequently removed prior to the current presentation.
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