Acute fibrinous and organizing pneumonia: A report of 2 cases and literature review / 解放军医学杂志

ABSTRACT

Objective To summarize and analyze the clinical and pathological characteristics of acute fibrinous and organizing pneumonia (AFOP). Methods The clinical data and the process of diagnosis and treatments of 2 patients diagnosed as AFOP were analyzed, combined with related literature review. Results The main clinical manifestations of the 2 patients (both males, aged 47 and 45 years respectively) were fever, cough, and dyspnea. The chest CT in one patient revealed lobar pneumonia in the right middle lobe of lung, and failed of antibiotic therapy. In another case, the chest CT revealed consolidation in the right upper lobe of lung, and the condition was improved initially by antibiotic therapy, but the symptoms aggravated again in a short time. Computed tomography guided percutaneous lung biopsy and transbronchial lung biopsy revealed the presence of intra-alveolar cellulose-like sediments, parts of which formed cellulose-like "balls", which were consistent of AFOP. The two patients showed clinical and radiological improvement after glucocorticoid therapy. One patient was treated with glucocorticoid for 3 months, and the other one was still on a tapering dose of steroids. Conclusions AFOP presents unique pathologic features, but no specific clinical features, patients with AFOP are easily misdiagnosed as pneumonia. Whether AFOP is an independent disease diagnosis is still a controversy.