Idiopathic Fibrotic Nonspecific Interstitial Pneumonia with Cicatricial Organizing Pneumonia and Intraluminal Pulmonary Ossification Containing Bone Marrow

Intern Med. 2024 Jul 15;63(14):2049-2052. doi: 10.2169/internalmedicine.2834-23. Epub 2023 Nov 20.

Abstract

A 72-year-old man presented with bilateral ground-glass opacities in the lower lung fields on chest radiography. Computed chest tomography showed ground-glass opacities and micronodules in both lower lungs. A video-assisted thoracoscopic biopsy of the right lower lung showed homogeneous thickening of the alveolar septa with fibrosis and inflammatory cell infiltration consistent with fibrotic non-specific interstitial pneumonia (fNSIP). Cicatricial organizing pneumonia and intraluminal pulmonary ossification containing bone marrow that was considered to represent dendriform pulmonary ossification. Idiopathic fNSIP was diagnosed. The patient remains stable under antifibrotic treatment.

Keywords: antifibrotic treatment; cicatricial organizing pneumonia; dendriform pulmonary ossification; fibrotic interstitial pneumonia.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Bone Marrow* / diagnostic imaging
  • Bone Marrow* / pathology
  • Cryptogenic Organizing Pneumonia / complications
  • Cryptogenic Organizing Pneumonia / diagnosis
  • Cryptogenic Organizing Pneumonia / diagnostic imaging
  • Cryptogenic Organizing Pneumonia / pathology
  • Humans
  • Idiopathic Interstitial Pneumonias / complications
  • Idiopathic Interstitial Pneumonias / diagnostic imaging
  • Idiopathic Interstitial Pneumonias / pathology
  • Idiopathic Pulmonary Fibrosis / complications
  • Idiopathic Pulmonary Fibrosis / diagnostic imaging
  • Idiopathic Pulmonary Fibrosis / pathology
  • Lung / diagnostic imaging
  • Lung / pathology
  • Lung Diseases, Interstitial / complications
  • Lung Diseases, Interstitial / diagnostic imaging
  • Lung Diseases, Interstitial / pathology
  • Male
  • Organizing Pneumonia
  • Ossification, Heterotopic* / complications
  • Ossification, Heterotopic* / diagnostic imaging
  • Ossification, Heterotopic* / pathology
  • Tomography, X-Ray Computed