Clinical features of acute fibrinous and organizing pneumonia: An early histologic pattern of various acute inflammatory lung diseases

Autor: Shin Sasaki, Takanori Higashino, Tetsuji Kawamura, Hiroaki Tsukamoto, Rokuro Mimura, Yasutaka Onishi
Rok vydání: 2021
Předmět:
Lung Diseases
Male
Pathology
Pulmonology
Biopsy
Biochemistry
Steroid Therapy
Diagnostic Radiology
Medical Conditions
Adrenal Cortex Hormones
Recurrence
Medicine and Health Sciences
Medicine
Connective Tissue Diseases
Tomography
Lung
Aged
80 and over
Multidisciplinary
medicine.diagnostic_test
Pharmaceutics
Radiology and Imaging
Middle Aged
C-Reactive Protein
medicine.anatomical_structure
Cryptogenic Organizing Pneumonia
Acute Disease
Female
Anatomy
medicine.symptom
Research Article
medicine.medical_specialty
Histology
Fever
Imaging Techniques
Science
Corticosteroid Therapy
Inflammatory Diseases
Surgical and Invasive Medical Procedures
Neuroimaging
Research and Analysis Methods
Drug Therapy
Diagnostic Medicine
Humans
Clinical significance
Pulmonary Eosinophilia
Halo sign
Aged
Retrospective Studies
Pneumonitis
Fibrin
business.industry
Myelodysplastic syndromes
Biology and Life Sciences
Proteins
Pneumonia
medicine.disease
Computed Axial Tomography
Tomography
X-Ray Computed
business
Neuroscience
Zdroj: PLoS ONE
PLoS ONE, Vol 16, Iss 4, p e0249300 (2021)
ISSN: 1932-6203
DOI: 10.1371/journal.pone.0249300
Popis: Background Acute fibrinous and organizing pneumonia (AFOP) is a rare histologic pattern of acute lung involvement with intra-alveolar fibrin deposition. However, the clinical significance of the pathological findings of AFOP remains unclear. This study aimed to explore the clinical significance of AFOP through a comprehensive clinical examination. Methods The medical records of patients with lung diseases accompanied by the pathological finding of intra-alveolar organization between January 2010 and December 2019 were retrospectively reviewed. The clinical and radiological findings were compared between the groups with and without the histologic pattern of AFOP. Results We identified 34 patients with AFOP (AFOP group) and 143 without AFOP (non-AFOP group). The underlying diseases of the AFOP group were as follows: 19 patients had cryptogenic organizing pneumonia (OP), 5 had connective tissue diseases, 3 had radiation pneumonitis, 3 had chronic eosinophilic pneumonia, 2 had myelodysplastic syndromes, and 2 had drug-induced pneumonia. Fever was more common, the time from symptom onset to biopsy was shorter, and the serum C-reactive protein level was higher in the AFOP group than in the non-AFOP group. On high-resolution computed tomography, 85% of patients had OP pattern, and halo sign was more common in the AFOP group. Corticosteroids were effective in 94% of the patients in the AFOP group; however, recurrences were more frequent, and a higher corticosteroid dose was needed during recurrence. Conclusions AFOP might be an early phase of a histologic pattern associated with known etiologies. In addition, it could be a marker indicating intense inflammatory diseases with a tendency of recurrence.
Databáze: OpenAIRE
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