title: Acute fibrinous and organizing pneumonia: A report of 13 cases in a tertiary university hospital.
abstract: BACKGROUND
  Acute fibrinous and organizing pneumonia (AFOP) is a rare diffuse pulmonary disease, but it is not yet known whether it is a distinct form of interstitial pneumonia or simply a reflection of a tissue sampling issue.
  
  
  METHODS
  Cross-sectional evaluation of clinical and radiological findings, treatments, and outcomes for patients with histologically confirmed AFOP at a tertiary university hospital between 2002 and 2015.
  
  
  RESULTS
  Thirteen patients (7 women, 53.8%) with a mean ± SD age of 53.5 ± 16.1 years were included. The main symptoms were fever (69.2%), cough (46.2%), and chest pain (30.8%). All patients presented a radiological pattern of consolidation and 5 (38.5%) had simultaneous ground-glass areas. Histology was obtained by computed tomography-guided transthoracic biopsy in 61.5% of cases and by surgical lung biopsy in the remaining cases. Several potential etiologic factors were identified. Eight patients (61.5%) had hematologic disorders and 3 had undergone an autologous hematopoietic cell transplant. Two (15.4%) had microbiologic isolates, 5 (38.4%) had drug-induced lung toxicity, and 2 (15.4%) were classified as having idiopathic AFOP. In addition to antibiotics and diuretics used to treat the underlying disease, the main treatment was corticosteroids, combined in some cases with immunosuppressants. Median survival was 78 months and 6 patients (46.2%) were still alive at the time of analysis.
  
  
  CONCLUSIONS
  Our findings for this series of patients confirm that AFOP is a nonspecific reaction to various agents with a heterogeneous clinical presentation and clinical course that seems to be influenced mainly by the severity of the underlying disorder.
authors.affiliation: Pulmonology Department, Hospital Sousa Martins, ULS-Guarda, Guarda, Portugal Faculty of Health Sciences, University of Beira Interior, Covilhã, Portugal Pulmonology Department, Centro Hospitalar de São João, Porto, Portugal Faculty of Medicine, University of Porto, Portugal Radiology Department, Centro Hospitalar de São João, Porto, Portugal Pathology Department, Centro Hospitalar de São João, Porto, Portugal.
authors.forename: Rita
authors.initials: R
authors.lastname: Gomes
authors.forename: Eva
authors.initials: E
authors.lastname: Padrão
authors.forename: Hans
authors.initials: H
authors.lastname: Dabó
authors.forename: Filipa
authors.initials: F
authors.lastname: Soares Pires
authors.forename: Patrícia
authors.initials: P
authors.lastname: Mota
authors.forename: Natália
authors.initials: N
authors.lastname: Melo
authors.forename: José Miguel
authors.initials: JM
authors.lastname: Jesus
authors.forename: Rui
authors.initials: R
authors.lastname: Cunha
authors.forename: Susana
authors.initials: S
authors.lastname: Guimarães
authors.forename: Conceição
authors.initials: C
authors.lastname: Souto Moura
authors.forename: António
authors.initials: A
authors.lastname: Morais
mesh_terms: D000208:Acute Disease; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D017563:Lung Diseases, Interstitial; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D011174:Portugal; D011658:Pulmonary Fibrosis / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D012307:Risk Factors