Online Images in the Medical Sciences| Volume 364, ISSUE 1, e4-e5, July 2022

Organizing pneumonia with solitary focal nodule and subsequent multiple pulmonary shadows

Published:January 23, 2022DOI:
      A 66-year-old woman was referred to us for evaluation of an asymptomatic nodule in the lung that had been detected through computed tomography (CT) examination during routine unit physical examination. A solitary focal nodule with halo sign (blue arrow) was demonstrated in the right upper lobe, 1.4 cm in diameter (Fig. 1A). Repeat CT 1 month later (Fig. 1B-D) showed subsequent multiple pulmonary shadows (red arrows). The patient had been diagnosed with depression 3 years ago and had been receiving long-term medications, such as mirtazapine, escitalopram oxalate, and lorazepam. She had no history of tuberculosis and was otherwise well. Laboratory examinations were normal, including blood routine, C-reactive protein, erythrocyte sedimentation rate and tumor markers. Photomicrograph of a lung biopsy (Fig. 1E-F) indicated massive fibrous tissue hyperplasia in the lung tissue and organizing pneumonia was diagnosed. Antipsychotic drugs were discontinued, and prednisone (1 mg/kg/day) was introduced. Repeat CT 6 days later (Fig. 1G) and 1 month later (Fig. 1H) detected a significant improvement (yellow arrows).
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