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Organizing pneumonia
From Libre Pathology

Organizing pneumonia, abbreviated OP, is a histologic

pattern in lung pathology. It fits into the larger category of Organizing pneumonia
diffuse lung diseases. Diagnosis in short

Contents
1 General
2 Microscopic
2.1 Images
2.2 Masson body Intraluminal
3 Sign out organization and
3.1 Micro polypoid
4 See also granulation tissue
5 References within a small
bronchiole

General
Multiple causes, e.g. transplant rejection, infection.

Clinical diagnoses:[1]

Transplant rejection.
Cryptogenic organizing pneumonia (COP), AKA
(idiopathic) bronchiolitis obliterans organizing
pneumonia (BOOP).
Should not be confused with constrictive Organizing pneumonia. H&E stain.
bronchiolitis (AKA bronchiolitis obliterans).
Collagen vascular disease. LM distal airway disease -- airways plugged
Toxic injury.
with organizing exudate (fluffy light-
Infection.
Peri-tumour - in proximity to a space-occupying lesion staining paucicellular regions with
(abscess, neoplasm). stellate cells); no hobnailing of
pneumocytes; type 2 pneumocytes
Note: hyperplasia is absent

BOOP is used as a synonym for organizing pneumonia LM DDx diffuse alveolar damage (proliferative
which has the long differential diagnosis above.[1] phase), bronchiolitis obliterans.
Confusingly, it may be used to refer to the Site lung - diffuse lung diseases
idiopathic form of organizing pneumonia, now
generally known as cryptogenic organizing
pneumonia (COP). Prevalence uncommon
In other words, strictly speaking, BOOP is Prognosis dependent on underlying cause
not the same as COP; idiopathic BOOP is
COP. Clin. DDx cryptogenic organizing pneumonia,
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Microscopic transplant rejection, infection

(pneumonia), collagen vascular disease,
Features:[2] peri-tumour
Treatment dependent on underlying cause
Distal airway disease -- airways plugged with organizing
exudate ("Masson bodies").
"Organized exudate" = fluffy light-staining paucicellular regions with stellate cells (fibroblasts &
immature connective tissue).
No hobnailing of pneumocytes.
Type 2 pneumocytes hyperplasia is absent.

DDx:

Diffuse alveolar damage, proliferative phase - has type 2 pneumoncyte hyperplasia.

Bronchiolitis obliterans.

Images

OP - very low mag. OP - low mag. OP - low mag. OP - intermed. mag.

(WC/Nephron) (WC/Nephron) (WC/Nephron) (WC/Nephron)

OP - intermed. mag. OP - high mag.

(WC/Nephron) (WC/Nephron)

Masson body

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Masson body - Masson body - high Masson body - very

intermed. mag. mag. (WC/Nephron) high mag.
(WC/Nephron) (WC/Nephron)

www:

BOOP (bmj.com) (http://casereports.bmj.com/content/2011/bcr.11.2010.3483.full).

Masson body (flickr.com) (http://www.flickr.com/photos/pulmonary_pathology/4733384977/).
Organizing pneumonia (flicker.com) (https://www.flickr.com/photos/pulmonary_pathology/3734401023).

Sign out

Lung, Right Lower Lobe, Open Lung Biopsy:

- Organizing pneumonia.
- Emphysematous changes.
- NEGATIVE for significant pulmonary fibrosis.
- NEGATIVE for malignancy.

Comment:
There is no evidence of granulomatous disease.

Micro

Organizing pneumonia with well-formed Masson bodies is seen subpleural and peribronchial. It is pathcy and mild.
Significant fibrosis is absent. Eosinophils are not readily apparent.

See also
Diffuse lung disease.
Pneumonia.

References
2. Klatt, Edward C. (2006). Robbins and Cotran Atlas of
1. Humphrey, Peter A; Dehner, Louis P; Pfeifer, John D Pathology (1st ed.). Saunders. pp. 110. ISBN 978-
(2008). The Washington Manual of Surgical Pathology 1416002741.
(1st ed.). Lippincott Williams & Wilkins. pp. 91.
ISBN 978-0781765275.

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