Organising pneumonia mimicking invasive fungal disease in patients with leukaemia.
Clinical charts from 63 consecutive highly immunocompromised haematologic patients presenting with pulmonary nodular lesions on CT scan, classified as either probable or possible invasive fungal disease (IFD) according to the revised EORTC/MSG classification, were retrospectively studied. Histopathological analysis of lung tissues, available for 23 patients, demonstrated proven IFD in 17 cases (14 invasive aspergillosis and 3 invasive zygomycosis), diffuse alveolar damage in one and organising pneumonia (OP) in five cases. In the OP cases, three of which have been defined as probable IFD according to EORTC/MSG classification, extensive immunohistochemical, molecular and immunological analyses for fungi were negative. Our case descriptions extend the notion that OP may be encountered as a distinct histopathological entity in pulmonary nodular lesions in patients with leukaemia with probable/possible IFD.
Department of Oncology, Haematology and Respiratory Diseases, Section of Haematology, University of Modena and Reggio Emilia, Azienda Ospedaliero-Universitaria Policlinico, Modena, Italy.
Fabio
F
Forghieri
Leonardo
L
Potenza
Monica
M
Morselli
Monica
M
Maccaferri
Letizia
L
Pedrazzi
Patrizia
P
Barozzi
Daniela
D
Vallerini
Giovanni
G
Riva
Eleonora
E
Zanetti
Chiara
C
Quadrelli
Giulio
G
Rossi
Francesco
F
Rivasi
Massimino
M
Messino'
Fabio
F
Rumpianesi
Antonella
A
Grottola
Claudia
C
Venturelli
Monica
M
Pecorari
Mauro
M
Codeluppi
Giuseppe
G
Torelli
Mario
M
Luppi
D000368:Aged; D001992:Bronchoalveolar Lavage Fluid / Q000382:microbiology; D018549:Cryptogenic Organizing Pneumonia / Q000175:diagnosis* / Q000209:etiology*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D055744:Invasive Pulmonary Aspergillosis / Q000175:diagnosis / Q000209:etiology; D015470:Leukemia, Myeloid, Acute / Q000150:complications* / Q000276:immunology; D008172:Lung Diseases, Fungal / Q000175:diagnosis* / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D009894:Opportunistic Infections / Q000175:diagnosis / Q000209:etiology; D012189:Retrospective Studies; D020096:Zygomycosis / Q000175:diagnosis / Q000209:etiology