Acute fibrinous and organising pneumonia presenting with mass-like imaging: a case report

Abstract Objective This case report describes a patient with acute fibrinous and organising pneumonia (AFOP) presenting with mass-like imaging on chest computed tomography (CT), aiming to enhance clinical awareness of this rare disease. Case presentation A 66-year-old man presented with cough, sputu...

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Main Authors: Wei Zhou, Longyun Zhang, Bin Xu, Chuanhai Wang
Format: Article
Language:English
Published: BMC 2025-04-01
Series:Diagnostic Pathology
Subjects:
Online Access:https://doi.org/10.1186/s13000-025-01654-x
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author Wei Zhou
Longyun Zhang
Bin Xu
Chuanhai Wang
author_facet Wei Zhou
Longyun Zhang
Bin Xu
Chuanhai Wang
author_sort Wei Zhou
collection DOAJ
description Abstract Objective This case report describes a patient with acute fibrinous and organising pneumonia (AFOP) presenting with mass-like imaging on chest computed tomography (CT), aiming to enhance clinical awareness of this rare disease. Case presentation A 66-year-old man presented with cough, sputum, chest tightness and weight loss persisting for 1 month. Chest X-ray revealed a space-occupying lesion in the left lung. Further CT imaging demonstrated irregular soft tissue masses in both the upper and lower lobes of the left lung. Although the imaging findings suggested lung cancer, the final pathological diagnosis confirmed AFOP. The patient was treated with methylprednisolone, resulting in substantial improvement of the upper lobe lesion, whereas the lower lobe lesion showed minimal response. Following the addition of mycophenolate mofetil, the lower lobe lesion decreased substantially. Multiple lung biopsies confirmed the diagnosis of AFOP, with no evidence of a malignant tumour. Conclusions Acute fibrinous and organising pneumonia presents with non-specific imaging findings, and when manifesting as a mass-like lesion, it may be misdiagnosed as lung cancer. Pathological examination remains essential for diagnosis. Close monitoring of the clinical response is crucial during treatment, and the treatment plan should be tailored to individual patient needs.
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spelling doaj-art-26be923f76ff4f7b822ffb47584afbf12025-08-20T02:30:18ZengBMCDiagnostic Pathology1746-15962025-04-012011710.1186/s13000-025-01654-xAcute fibrinous and organising pneumonia presenting with mass-like imaging: a case reportWei Zhou0Longyun Zhang1Bin Xu2Chuanhai Wang3Department of Ultrasound, Shengli Oilfield Central HospitalDepartment of Ultrasound, Shengli Oilfield Central HospitalDepartment of Pathology, Shengli Oilfield Central HospitalDepartment of Respiratory and Critical Care Medicine, Shengli Oilfield Central HospitalAbstract Objective This case report describes a patient with acute fibrinous and organising pneumonia (AFOP) presenting with mass-like imaging on chest computed tomography (CT), aiming to enhance clinical awareness of this rare disease. Case presentation A 66-year-old man presented with cough, sputum, chest tightness and weight loss persisting for 1 month. Chest X-ray revealed a space-occupying lesion in the left lung. Further CT imaging demonstrated irregular soft tissue masses in both the upper and lower lobes of the left lung. Although the imaging findings suggested lung cancer, the final pathological diagnosis confirmed AFOP. The patient was treated with methylprednisolone, resulting in substantial improvement of the upper lobe lesion, whereas the lower lobe lesion showed minimal response. Following the addition of mycophenolate mofetil, the lower lobe lesion decreased substantially. Multiple lung biopsies confirmed the diagnosis of AFOP, with no evidence of a malignant tumour. Conclusions Acute fibrinous and organising pneumonia presents with non-specific imaging findings, and when manifesting as a mass-like lesion, it may be misdiagnosed as lung cancer. Pathological examination remains essential for diagnosis. Close monitoring of the clinical response is crucial during treatment, and the treatment plan should be tailored to individual patient needs.https://doi.org/10.1186/s13000-025-01654-xAcute fibrinous and organising pneumoniaMassComputed tomographyBiopsy
spellingShingle Wei Zhou
Longyun Zhang
Bin Xu
Chuanhai Wang
Acute fibrinous and organising pneumonia presenting with mass-like imaging: a case report
Diagnostic Pathology
Acute fibrinous and organising pneumonia
Mass
Computed tomography
Biopsy
title Acute fibrinous and organising pneumonia presenting with mass-like imaging: a case report
title_full Acute fibrinous and organising pneumonia presenting with mass-like imaging: a case report
title_fullStr Acute fibrinous and organising pneumonia presenting with mass-like imaging: a case report
title_full_unstemmed Acute fibrinous and organising pneumonia presenting with mass-like imaging: a case report
title_short Acute fibrinous and organising pneumonia presenting with mass-like imaging: a case report
title_sort acute fibrinous and organising pneumonia presenting with mass like imaging a case report
topic Acute fibrinous and organising pneumonia
Mass
Computed tomography
Biopsy
url https://doi.org/10.1186/s13000-025-01654-x
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