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Presented by Pedram Argani, M.D. and prepared by Doreen Nguyen, M.D.
Case 1: a 54 year old female with lung nodules.
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Question 1 of 1
1. Question
Week 603: Case 1
This is a 54 year old female with lung nodules.
Correct
Answer: Bronchiolitis obliterans organizing pneumonia
Histology: The lung demonstrates a well-defined nodular area, which features interstitial chronic inflammation along with plugs of granulation tissue which branch within air spaces. The septa show no evidence of acute injury such as fibrin deposition or highly reactive pneumocytes. No granulomas are seen. These are the typical features of bronchiolitis obliterans organizing pneumonia (BOOP).
Discussion: BOOP is a pattern of bronchiole-centered lung injury. It can be seen as a primary process (in which it can be either idiopathic or secondary to drug, infection, collagen vascular disease), adjacent to another process such as a neoplasm or infection, or as a component of another pulmonary process such hypersensitivity pneumonitis or eosinophilic pneumonia.
Diffuse alveolar damage will demonstrate interstitial edema and myxoid change, along with alveolar injury including hyaline membranes and reactive pneumocytes. Sarcoidosis is a granulomatous process that is unassociated with BOOP. Lymphocytic interstitial pneumonitis is a diffuse interstitial chronic inflammatory process which again lacks BOOP.
Incorrect
Answer: Bronchiolitis obliterans organizing pneumonia
Histology: The lung demonstrates a well-defined nodular area, which features interstitial chronic inflammation along with plugs of granulation tissue which branch within air spaces. The septa show no evidence of acute injury such as fibrin deposition or highly reactive pneumocytes. No granulomas are seen. These are the typical features of bronchiolitis obliterans organizing pneumonia (BOOP).
Discussion: BOOP is a pattern of bronchiole-centered lung injury. It can be seen as a primary process (in which it can be either idiopathic or secondary to drug, infection, collagen vascular disease), adjacent to another process such as a neoplasm or infection, or as a component of another pulmonary process such hypersensitivity pneumonitis or eosinophilic pneumonia.
Diffuse alveolar damage will demonstrate interstitial edema and myxoid change, along with alveolar injury including hyaline membranes and reactive pneumocytes. Sarcoidosis is a granulomatous process that is unassociated with BOOP. Lymphocytic interstitial pneumonitis is a diffuse interstitial chronic inflammatory process which again lacks BOOP.
