A 70-year-old man presented to our hospital because of a cough with bright red blood for 1 month. A chest computed tomography (CT) scan showed that there was a patchy, dense shadow below the pleura of the upper lobe of the left lung. This shadow was approximately 2.7 × 2.2 cm in size, with rough edges, adjacent pleural traction, and localized thickening. Percutaneous pulmonary needle biopsy was performed under CT guidance. Morphological features were characterized by multifocal centrilobular distribution of fibromyxoid polyps of granulation tissue in the lumen of distal airspaces and small bronchioles. These findings supported the diagnosis of focal cryptogenic organizing pneumonia. The patient was then treated with ceftazidime and prednisone. After this treatment, the patient visited the clinic and complete resolution of his respiratory symptoms and nearly complete resolution of the mass on chest CT were observed. The findings in our case provide clinical experience to help with the diagnosis of cryptogenic organizing pneumonia, which is difficult to diagnose.
Keywords: Cryptogenic organizing pneumonia; ceftazidime; granulation tissue; lungs; percutaneous pulmonary needle biopsy; prednisone.