Liu WJ, Zhou S, Li YX. Two methods of lung biopsy for histological confirmation of acute fibrinous and organizing pneumonia: A case report. World J Clin Cases 2022; 10(36): 13381-13387 [PMID: 36683623 DOI: 10.12998/wjcc.v10.i36.13381]
Corresponding Author of This Article
Yan-Xia Li, PhD, Doctor, Full Professor, Department of Respiratory and Critical Care Medicine, Institute of Respiratory Diseases, The First Affiliated Hospital of Dalian Medical University, No. 222 Zhongshan Road, Dalian 116011, Liaoning Province, China. liyanxia001@163.com
Research Domain of This Article
Respiratory System
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Dec 26, 2022; 10(36): 13381-13387 Published online Dec 26, 2022. doi: 10.12998/wjcc.v10.i36.13381
Two methods of lung biopsy for histological confirmation of acute fibrinous and organizing pneumonia: A case report
Wen-Juan Liu, Shuang Zhou, Yan-Xia Li
Wen-Juan Liu, Yan-Xia Li, Department of Respiratory and Critical Care Medicine, Institute of Respiratory Diseases, The First Affiliated Hospital of Dalian Medical University, Dalian 116011, Liaoning Province, China
Shuang Zhou, Department of Internal Medicine, Dalian Medical University, Dalian 116044, Liaoning Province, China
Author contributions: Liu WJ contributed to data analysis and wrote the paper; Zhou S contributed to data collection; Li YX contributed to the conception and design of the study; all authors revised the paper and approved the submitted version.
Supported byNatural Science Foundation of Liaoning Province, No. 2021-MS-287.
Informed consent statement: The patient provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yan-Xia Li, PhD, Doctor, Full Professor, Department of Respiratory and Critical Care Medicine, Institute of Respiratory Diseases, The First Affiliated Hospital of Dalian Medical University, No. 222 Zhongshan Road, Dalian 116011, Liaoning Province, China. liyanxia001@163.com
Received: September 6, 2022 Peer-review started: September 6, 2022 First decision: September 26, 2022 Revised: October 17, 2022 Accepted: November 28, 2022 Article in press: November 28, 2022 Published online: December 26, 2022 Processing time: 106 Days and 6.1 Hours
Abstract
BACKGROUND
Acute fibrinous and organizing pneumonia (AFOP) is a rare, noninfective lung disease, histologically characterized by a patchy distribution of intra-alveolar fibrin “balls” and organizing pneumonia. The clinical manifestations of AFOP are nonspecific. Diagnosis depends on pathology. Surgical lung biopsy is optimal for tissue sampling to diagnose AFOP. However, many patients have no tolerance to the operation, including mentally and physically. There is still no standard therapy for AFOP and the methods remain controversial. Therefore, further clinical attention and discussion are warranted.
CASE SUMMARY
A 53-year-old woman presented with fever, cough and dyspnea for 15 d. Anti-infective therapy was ineffective. Chest computed tomography showed bilateral patchy consolidation, especially in the lower lobes. We performed both ultrasound-guided transbronchial lung biopsy and ultrasound-guided percutaneous fine needle puncture at different lung lesion locations. Both samples supported the diagnosis of AFOP. The patient had a good clinical course after treatment with methylprednisolone, and no side effects of steroids.
CONCLUSION
Percutaneous needle biopsy combined with transbronchial lung biopsies may be a good choice in the absence of surgical biopsy. Methylprednisolone alone is effective in the treatment of idiopathic AFOP.
Core Tip: We describe the case of a 53-year-old woman with fever, cough and dyspnea for 15 d. Chest computed tomography showed rapidly progressive bilateral patchy consolidation especially in the lower lobes. Anti-infective therapy was ineffective. We performed ultrasound-guided transbronchial lung biopsy of the posterior basal segment of the left lung and ultrasound-guided percutaneous fine needle puncture of the right lung nodule. Both samples supported the diagnosis of acute fibrinous and organizing pneumonia (AFOP). Methylprednisolone alone is effective and safe in the treatment of idiopathic AFOP.
