J Korean Radiol Soc.
2000 Dec;43(6):711-715. 10.3348/jkrs.2000.43.6.711.
CT Findings of Focal Organizing Pneumonia
- Affiliations
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- 1Department of Diagnostic Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Korea. kimydrt@yumc.yonsei.ac.kr
- 2Department of Diagnostic Radiology, Gachon Medical School, GIL General Hospital, Korea.
- 3Department of Diagnostic Radiology, College of Medicine, Inje University, Korea.
- 4Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
- 5Department of Chest Surgery, Yonsei University College of Medicine, Seoul, Korea
- KMID: 2200469
- DOI: http://doi.org/10.3348/jkrs.2000.43.6.711
Abstract
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PURPOSE: Focal organizing pneumonia (FOP) is a benign condition which is often difficult to differentiate from bronchogenic carcinoma, and many patients with FOP undergo invasive procedures. We tried to determine which CT features might help provide a confident diagnosis of FOP.
MATERIALS AND METHODS
We retrospectively reviewed the medical records, chest radiographs and CT scans of 13 patients with histopathologically proven FOP. Initial chest radiographs in all 13 suggested bronchogenic carcinoma. The CT scans were reviewed by three radiologists, and final decisions were reached by consensus. They were analyzed in terms of the size, shape, contour and localization of the lesion, internal characteristics of the nodule, changes in surrounding structures, and changes in any of these findings, as revealed by follow-up chest CT scanning.
RESULTS
FOP lesions were oval or triangular in shape and between 1.8 and 6.5 cm in their largest diameter. All had irregular margins and all but one were peripherally located. Eight (61.5%) were in contact with the pleura and five (38.5%) were located along the peripheral bronchovascular bundle, with pleural indentation; in eight (61.5%), post-contrast CT scanning revealed inhomogeneous enhancement, and four (30.8%) had pleural tags. In five (38.5%), there was coarse spiculation; for six (46.2%), air bronchograms were available, and in four (30.8%), satellite nodules were present. Spotty calcification and lymph node enlargement were each evident in one case only. Follow-up CT scanning, available in four cases, showed that the mass decreased in size in three and disappeared completely in one.
CONCLUSION
Although there were no consistent CT features for differentiating focal organizing pneumonia from lung cancer, the possibility of the former should be considered when a peripherally-located oval or triangular-shaped mass is in broad contact with the pleura or is located along the bronchovascular bundle, and satellite nodules are also present.
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