American Journal of Roentgenology, Vol 170, 291-295, Copyright © 1998 by American Roentgen Ray Society

ARTICLES

Bronchiolitis obliterans organizing pneumonia manifesting as multiple large nodules or masses

M Akira, S Yamamoto and M Sakatani
Department of Radiology, National Kinki Chuo Hospital for Chest Disease, Osaka, Japan.

OBJECTIVE: The purpose of this study was to describe the CT features and clinical features in bronchiolitis obliterans organizing pneumonia (BOOP) that manifest as multiple large nodules or masses. MATERIALS AND METHODS: We reviewed thin-section CT scans and clinical records of 12 patients with histologically proven BOOP manifesting as multiple large nodules or masses. For all patients follow-up CT scans were available, which we also reviewed. RESULTS: Of 60 lesions found in the 12 patients, 53 (88%) had an irregular margin, 27 (45%) had an air bronchogram, 23 (38%) had a pleural tag, and 21 (35%) had spicules. Ancillary findings included focal thickening of the interlobular septa in five (42%) of the 12 patients, pleural thickening in four (33%) patients, and parenchymal bands in three (25%) patients. Follow-up CT scans showed that the lesions with surrounding ground-glass attenuation evolved into lesions with pleural tags or parenchymal bands or both. CONCLUSION: BOOP should be considered when multiple large nodular lesions are seen on chest CT. In particular, BOOP should be considered when the lesions contain air bronchograms; have irregular margins, relatively broad pleural tags in contact with the pleura, parenchymal bands, or subpleural lines; or are associated with focal thickening of interlobular septa.
CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				K. A. White and L. A. Ruth-Sahd Bronchiolitis Obliterans Organizing Pneumonia Crit. Care Nurse, June 1, 2007; 27(3): 53 - 66. [Full Text] [PDF]

				G. Melloni, G. Cremona, A. Bandiera, G. Arrigoni, N. Rizzo, R. Varagona, G. Muriana, A. Carretta, P. Ciriaco, B. Canneto, et al. Localized Organizing Pneumonia: Report of 21 Cases Ann. Thorac. Surg., June 1, 2007; 83(6): 1946 - 1951. [Abstract] [Full Text] [PDF]

				M. B Gotway, M. M Freemer, and T. E King Jr Challenges in pulmonary fibrosis {middle dot} 1: Use of high resolution CT scanning of the lung for the evaluation of patients with idiopathic interstitial pneumonias Thorax, June 1, 2007; 62(6): 546 - 553. [Abstract] [Full Text] [PDF]

				C. Mueller-Mang, C. Grosse, K. Schmid, L. Stiebellehner, and A. A. Bankier What Every Radiologist Should Know about Idiopathic Interstitial Pneumonias RadioGraphics, May 1, 2007; 27(3): 595 - 615. [Abstract] [Full Text] [PDF]

				C. M. Park, J. M. Goo, H. J. Lee, C. H. Lee, E. J. Chun, and J.-G. Im Nodular Ground-Glass Opacity at Thin-Section CT: Histologic Correlation and Evaluation of Change at Follow-up RadioGraphics, March 1, 2007; 27(2): 391 - 408. [Abstract] [Full Text] [PDF]

				E. P. Hochberg, M. D. Gilman, and R. P. Hasserjian Case records of the Massachusetts General Hospital. Case 17-2006--a 34-year-old man with cavitary lung lesions. N. Engl. J. Med., June 8, 2006; 354(23): 2485 - 2493. [Full Text] [PDF]

				M. Ujita, E. A. Renzoni, S. Veeraraghavan, A. U. Wells, and D. M. Hansell Organizing Pneumonia: Perilobular Pattern at Thin-Section CT Radiology, September 1, 2004; 232(3): 757 - 761. [Abstract] [Full Text] [PDF]

				J. Y. H. Hui, D. H. Y. Cho, M. K. W. Yang, K. Wang, K. K. L. Lo, W. C. Fan, C. C. Chan, C. M. Chu, T. K. L. Loke, and J. C. S. Chan Severe Acute Respiratory Syndrome: Spectrum of High-Resolution CT Findings and Temporal Progression of the Disease Am. J. Roentgenol., December 1, 2003; 181(6): 1525 - 1538. [Full Text] [PDF]

				C. M. Fleming, J.-A. O. Shepard, and E. J. Mark Case 15-2003 - A 47-Year-Old Man with Waxing and Waning Pulmonary Nodules Five Years after Treatment for Testicular Seminoma N. Engl. J. Med., May 15, 2003; 348(20): 2019 - 2027. [Full Text] [PDF]

				S. J. Kim, K. S. Lee, Y. H. Ryu, Y. C. Yoon, K. O. Choe, T. S. Kim, and K. J. Sung Reversed Halo Sign on High-Resolution CT of Cryptogenic Organizing Pneumonia: Diagnostic Implications Am. J. Roentgenol., May 1, 2003; 180(5): 1251 - 1254. [Abstract] [Full Text] [PDF]

				American Thoracic Society/European Respiratory Society International Multidisciplinary Consensus Classification of the Idiopathic Interstitial Pneumonias . This Joint Statement of the American Thoracic Society (ATS), and the European Respiratory Society (ERS) was adopted by the ATS Board of Directors, June 2001 and by The ERS Executive Committee, June 2001 Am. J. Respir. Crit. Care Med., January 15, 2002; 165(2): 277 - 304. [Full Text] [PDF]

				H. Arakawa, Y. Kurihara, H. Niimi, Y. Nakajima, T. Johkoh, and H. Nakamura Bronchiolitis Obliterans with Organizing Pneumonia Versus Chronic Eosinophilic Pneumonia: High-Resolution CT Findings in 81 Patients Am. J. Roentgenol., April 1, 2001; 176(4): 1053 - 1058. [Abstract] [Full Text] [PDF]

				G. R. Epler Bronchiolitis Obliterans Organizing Pneumonia Arch Intern Med, January 22, 2001; 161(2): 158 - 164. [Abstract] [Full Text] [PDF]

				J.-F. Cordier Rare diseases bullet 8: Organising pneumonia Thorax, April 1, 2000; 55(4): 318 - 328. [Full Text]

				A. Gul, D. Yilmazbayhan, N. Buyukbabani, J. T. Lie, M. Tunaci, A. Tunaci, M. Inanc, L. Ocal, O. Aral, and M. Konice Organizing pneumonia associated with pulmonary artery aneurysms in Behcet's disease Rheumatology, December 1, 1999; 38(12): 1285 - 1289. [Full Text] [PDF]