Abstract
Objective:Organizing pneumonia (OP) is a rare lung condition that is characterized by the presence of polypoid tissues due to fibroblastic plugs within respiratory bronchioles, alveolar ducts and sacs. The three main radiologic patterns of OP include typical, solitary-focal and infiltrative forms. The maximum standardized uptake value (SUVmax) on positron emission tomography-computed tomography (PET/CT) may be high in benign conditions such as OP as well as malignant diseases. The aim of our study was to investigate PET-CT characteristics of OP in patients mimicking lung cancer.Methods:The clinical and radiologic characteristics of 50 patients who were referred to our hospital for PET/CT evaluation due to suspicion of lung malignancy, and who were pathologically diagnosed as OP between 2009 and 2013 were retrospectively reviewed.Results:The mean age of the patients was 58.2 years. Ninety-six percent of patients (48) were male. Radiologic evaluation revealed 27 (54%) focal involvement, 10 (20%) consolidation with air-bronchogram (typical), 1 (2%) infiltrative and 12 (24%) other types of involvement (multiple nodules and cavitary lesions). The mean SUVmax value of the lesions on PET/CT was calculated as 6.5. Mediastinal lymph node involvement (at least one station) was detected in 76% of our study group with a mean SUVmax value of 3.27.Conclusion:OP may cause false positive results on PET/CT. However, PET/CT results may be used as a guide for invasive procedures that should be performed when there is suspicion of malignancy.
Highlights
IntroductionThe etiologies of Organizing Pneumonia (OP) include infectious pneumonia, connective tissue diseases, inflammatory bowel diseases, solid organ transplantation, drugs, radiotherapy or aspiration [1]
Organizing Pneumonia (OP) is pathologically defined by the presence of buds of granulation tissue composed of fibroblasts, myofibroblasts, fibrin and collagen exudates (Masson bodies) within the respiratory bronchioles, alveolar ducts and sacs.The etiologies of OP include infectious pneumonia, connective tissue diseases, inflammatory bowel diseases, solid organ transplantation, drugs, radiotherapy or aspiration [1]
The clinical and radiologic characteristics of 50 patients who were referred to our hospital for evaluation with positron emission tomography-computed tomography (PET/CT) due to suspected lung malignancy, and who were pathologically diagnosed as OP between 2009 and 2013 were retrospectively reviewed
Summary
The etiologies of OP include infectious pneumonia, connective tissue diseases, inflammatory bowel diseases, solid organ transplantation, drugs, radiotherapy or aspiration [1]. It is called Cryptogenic Organizing Pneumonia (COP) if an underlying cause cannot be foundorganizing. Nodules, cavitary lesions, bronchocentric distribution, inverse halo pattern, band-like opacities, pneumatocele and pleurisy may be detected in patients with OP [2]. PET/CT, which is especially used for diagnosis, staging, evaluation of response to treatment and distant metastasis in malignant diseases, is a hybrid imaging method that combines anatomic and functional features It is used for central nervous system, vascular, inflammatory, and infectious diseases. It can guide the site to be sampled, and identify the primary focus if there are multiple lesions
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