Marques G, Annweiler T, Raoux D, Tiffet O, Vergnon J-M, Bertoletti L
Faculté de médecine, université Jean-Monnet, 15 rue Ambroise-Paré, Saint-Étienne, France.
Rev Pneumol Clin. 2011 Oct;67(5):314-7. doi: 10.1016/j.pneumo.2010.06.004. Epub 2010 Dec 3.
Cryptogenic organizing pneumonia is inflammatory and proliferative pulmonary diseases whose specific radiologic feature are bilateral and migrant opacities.
An isolated peripheral nodule of the left lower lobe was discovered on chest X-ray of a man who presented with isolated chronic cough. As this nodule has a positive FDG positron emission tomography uptake (PET) but with inconclusive fiberoptic bronchoscopy, the patient was sent to surgeon and a wedge-resection was processed because intraoperative analysis did not show any tumour. Histopathological study was in favour of organizing pneumonia. Search for potential cause remained negative and the diagnosis of cryptogenic organizing pneumonia was retained.
Cryptogenic organizing pneumonia may mimic lung cancer, presenting as an isolated peripheral nodule with positive PET. Histopathological study remains absolutely necessary to retain the diagnosis because of dramatic differences in prognosis and therapy.
隐源性机化性肺炎是一种炎症性和增殖性肺部疾病,其特定的放射学特征是双侧游走性阴影。
一名以慢性咳嗽为唯一症状的男性患者,胸部X线检查发现左肺下叶有一个孤立的外周结节。由于该结节氟代脱氧葡萄糖正电子发射断层扫描(FDG PET)摄取呈阳性,但纤维支气管镜检查结果不明确,该患者被转诊至外科医生处,接受了楔形切除术,因为术中分析未发现任何肿瘤。组织病理学研究支持机化性肺炎的诊断。对潜在病因的检查结果为阴性,最终确诊为隐源性机化性肺炎。
隐源性机化性肺炎可能酷似肺癌,表现为PET阳性的孤立外周结节。由于预后和治疗存在显著差异,组织病理学研究对于确诊仍然绝对必要。