Localized organizing pneumonia: report of 21 cases.
BACKGROUND
Thoracic surgeons have limited experience with treating localized organizing pneumonia owing to its rare occurrence in routine clinical practice.


METHODS
We retrospectively investigated the clinicopathologic features of 21 patients with localized organizing pneumonia observed between 2001 and 2004.


RESULTS
There were 15 men and 6 women. Mean age was 63 years. Eight patients (38%) were symptomatic. Computed tomographic scan showed a single lesion in 17 patients (12 nodules and 5 masses) and bilateral lesions in 4. Wedge resection was performed in 16 patients and lobectomy in 5. There was no operative mortality. Follow-up was complete in all patients (range, 2 to 46 months; median, 20 months). Surgery was curative in 15 of 17 patients with a single lesion, and no recurrence was observed (p < 0.005). The remaining 2 patients with a single lesion (2 masses) had a local relapse with the appearance of nodular lesions in the residual parenchyma. Both these patients received steroids with resolution of the lesions. All 4 patients with bilateral lesions who underwent surgery for diagnostic purposes received steroids with improvement of the radiologic aspect in 3 and stabilization of the lesions in 1.


CONCLUSIONS
Clinical and radiologic findings of localized organizing pneumonia are nonspecific, and this unusual entity is difficult to differentiate from a primary or metastatic tumor. Surgical resection allows both diagnosis and cure. However, considering the benignity of the lesion and the efficacy of steroids, major pulmonary resections should be avoided.
Melloni
Giulio
G
Department of Thoracic Surgery, San Raffaele Scientific Institute, Milan, Italy. giulio.melloni@hsr.it
Cremona
George
G
Bandiera
Alessandro
A
Arrigoni
Gianluigi
G
Rizzo
Nathalie
N
Varagona
Roberto
R
Muriana
Giovanni
G
Carretta
Angelo
A
Ciriaco
Paola
P
Canneto
Barbara
B
Zannini
Piero
P
D000368:Aged; D000369:Aged, 80 and over; D018549:Cryptogenic Organizing Pneumonia / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012008:Recurrence; D012189:Retrospective Studies