Breast cancer and organising pneumonia: the importance of correlating the pathological findings with the clinical and radiological picture

BMJ Case Reports
Paul GriffithsDuncan Fullerton

Abstract

This case describes a female patient with a history of breast cancer who presented with a persistent cough and weight loss after a 17-year disease-free period. Radiologically there were new bilateral intrapulmonary nodules and areas of consolidation with a broad differential diagnosis. Brushings gained via bronchoscopy were suggestive of malignancy, but subsequent video-assisted thoracoscopic surgery wedge resection demonstrated organising pneumonia (OP) with no evidence of malignancy. Diagnostic uncertainty remained after this, and after a period of observation, there was evidence of disease progression. Further tissue was obtained for cytological and histological assessment which provided conclusive evidence of metastatic breast cancer. In this case, OP was secondary to proximal bronchial obstruction due to metastatic infiltration, of which there are no reported similar cases in the current literature. We discuss the importance of differentiating secondary OP from cryptogenic OP.

References

Mar 29, 2003·The European Respiratory Journal·E RadzikowskaI Bestry
Aug 8, 2007·Clinical Lung Cancer·Stefan SteurerFelix Lintner
Nov 15, 2013·Radiographics : a Review Publication of the Radiological Society of North America, Inc·Seth J KligermanJeffrey R Galvin
Mar 31, 2017·Molecular and Clinical Oncology·Akinori SugayaHiroshi Kojima

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