%0 Journal Article
%T Empiric Treatment of Focal Organizing Pneumonia in a Patient with a Low-Risk Lung Mass
%A Mir Alikhan
%A Srihari Veeraraghavan
%J Case Reports in Pulmonology
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/340202
%X The authors present a case of a 57-year-old man presenting with a solitary lung mass. Transbronchial biopsy showed an organizing pneumonia pattern. A therapeutic trial of corticosteroids resulted in complete resolution avoiding surgery. The authors discuss the diagnosis of focal organizing pneumonia without surgical resection. 1. Case Presentation A 57-year-old male was referred to the pulmonary clinic for an abnormal computed tomography (CT) scan. The patient initially presented to his primary care physician with two weeks of dry cough, fatigue, and body aches. He underwent a chest radiograph and CT scan of the chest, which showed a mass in the right middle lobe. He denied any symptoms of shortness of breath, wheezing, hemoptysis, fever, or weight loss. The patient¡¯s past medical history is significant for hypertension, hyperlipidemia, and gastroesophageal reflux disease. He has never smoked cigarettes and denied use of alcohol or illicit drugs. The patient did not have any significant medication, environmental, or occupational exposures. He also did not have any pets in his home. He denied history of significant travel or ill contacts. His family history was insignificant for any respiratory diseases or malignancy. On physical examination, the patient was a well-appearing, middle-aged Caucasian male. He was in no respiratory distress and had normal vital signs. His pulmonary exam demonstrated clear bilateral breath sounds without rales or rhonchi, and the remainder of his exam was otherwise unremarkable. Laboratory data obtained prior to his initial evaluation demonstrated a normal chemistry panel except for an elevated creatinine (1.45£¿mg/dL). Complete blood count demonstrated a mild leukocytosis (11.9 ¡Á 103/¦ÌL) and normocytic anemia (10.9£¿g/dL). No other serum analysis was performed. Pulmonary function tests revealed normal spirometry, lung volumes, and diffusion capacity. Chest radiograph demonstrated a mass in the lateral segment of the right middle lobe with an otherwise normal appearance of the lung parenchyma (Figure 1). Figure 1: Chest radiograph demonstrating a large mass in the right middle lobe. CT scan of the chest with intravenous contrast was also performed. This was most significant for a right middle lobe mass measuring 4.4£¿cm ¡Á 4.8£¿cm (Figure 2). There were no pathologically enlarged lymph nodes or pulmonary embolus. The remainder of the lung parenchyma was normal in appearance. Figure 2: Chest CT scan demonstrating a large, rounded mass in the periphery of the right middle lobe. Given the combination of findings, fluoroscopic guided
%U http://www.hindawi.com/journals/cripu/2013/340202/