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Organising pneumonia mimicking invasive fungal disease in patients with leukaemia

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Abstract

Clinical charts from 63 consecutive highly immunocompromised haematologic patients presenting with pulmonary nodular lesions on CT scan, classified as either probable or possible invasive fungal disease (IFD) according to the revised EORTC/MSG classification, were retrospectively studied. Histopathological analysis of lung tissues, available for 23 patients, demonstrated proven IFD in 17 cases (14 invasive aspergillosis and 3 invasive zygomycosis), diffuse alveolar damage in one and organising pneumonia (OP) in five cases. In the OP cases, three of which have been defined as probable IFD according to EORTC/MSG classification, extensive immunohistochemical, molecular and immunological analyses for fungi were negative. Our case descriptions extend the notion that OP may be encountered as a distinct histopathological entity in pulmonary nodular lesions in patients with leukaemia with probable/possible IFD.
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Keywords: invasive fungal disease; leukaemia; lung histopathology; organising pneumonia

Document Type: Research Article

Affiliations: 1: Department of Oncology, Haematology and Respiratory Diseases, Section of Haematology 2: Department of Diagnostic and Laboratory Services and Legal Medicine, Section of Pathology 3: Department of Diagnostic and Laboratory Services and Legal Medicine, Microbiology and Virology Unit 4: Department of Internal Medicine, Section of Infectious Diseases, University of Modena and Reggio Emilia, Azienda Ospedaliero-Universitaria Policlinico, Modena, Italy

Publication date: July 1, 2010

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