Clinical Studies of Organizing Pneumonia Simulating Lung Cancer : The value of bronchography for diagnosis

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  • 肺癌を疑われた器質化肺炎 10 例の臨床的検討 : 気管支造影の診断的有用性について

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Abstract

We have reported ten cases of organizing pneumonia diagnosed by histological study of surgical specimen (2 cases), transbronchial lung biopsy (4 cases) or clinical feature (4 cases). All these cases were initially regarded as lung cancer, because the symptoms of respiratory tract infection were not remarkable and their initial roentgenographic findings revealed a tumor-like shadow. The bronchographic finding showed poor distribution in 10 cases, bronchial wall irregularity in 6 cases and longitudinally extensive stenosis in 10 cases. Interruption, i.c. disturbance of passage of contrast medium into several peripheral bronchi, was recognized in all but one case. However, such interruption seemed to differ from the obstruction observed in lung cancer. In some cases, moreover, dilatation (2 cases), central conference of bronchi (3 cases) or small cavity-formation (2 cases) were also recognized. It seemed that these findings were never indicative of malignant lesion but inflammatory process. Hence, bronchographic procedure which was very useful in differentiating organizing pneumonia from lung cancer in our experience should be always performed in evaluating localized mass shadow for diagnosis. In addition to get much information as possible from clinical history, adequate diagnostic approach including bronchography may be able to decrease unnecessary exploratory thoracotomy with significant hazard for some patients.

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