hematol transfus cell ther. 2 0 2 0; 4 2(2) :176–179
www.htct.com.br
Hematology, Transfusion and Cell Therapy
Case Report
Organizing pneumonia in a patient with hodgkin’s
lymphoma and large B cell lymphoma: a rare
association
Jaume Bordas-Martinez
*
, Mercè Gasa, Eva Domingo-Domènech,
Vanesa Vicens-Zygmunt
Bellvitge Universitary Hospital, L’Hospitalet, Barcelona, Spain
a r t i c l e i n f o
Article history:
Received 1 May 2019
Accepted 7 June 2019
Available online 7 September 2019
Organizing Pneumonia (OP) is classified as an Idiopathic
Interstitial Pneumonia (IIP).
1
Clinically, the patients present
dyspnea, cough, and low fever, and usually respond well to
corticosteroids, reaching clinical and radiologic resolution in
a short timeframe. However, sometimes infiltrates do recur
and may not resolve. Radiologically, migratory consolida-
tions are identified in high-resolution computed tomography
(HRCT), sometimes associated with progressive fibrosis with
reticulation and areas of persistent consolidation.
1
The his-
tology reveals “proliferation of fibroblastic tissue within small
airways, alveolar ducts, and alveolar spaces”.
2
OP can be
secondary to other pathologies such as common variable
immunodeficiency
3
and malignant disease among others.
4
At times no etiology is identified and the term Cryptogenic
Organizing Pneumonia (COP) is used.
1
Furthermore, OP could
coexist or mimic a malignant disease.
4,5
We present a case of a 56-year-old (y/o) man, ex-smoker
of 19 pack-years, an engineer without any contact with
chemical products. He lived in a flat without detectable expo-
sures, and indicated no alcohol or drug abuse. In 2002 (41
*
Corresponding author at: Department of Pulmonology, Bellvitge University Hospital, c/FeixaLlarga S/N, L’Hospitalet, 08907, Barcelona,
Spain.
E-mail address: jbordas@bellvitgehospital.cat (J. Bordas-Martinez).
y/o), he was monitored by other center due to dispnea,
non-productive cough and low-grade fever. There were no
remarkable indicators during physical examination (no patho-
logical breathing sounds, 98% oxygen saturation at room
air). Laboratory studies highlighted neutrophil-predominant
leukocytosis and elevated level of C-reactive protein. X-ray
findings and High-Resolution Computed Tomography (HRCT)
showed lung infiltrates that migrated from one relapse to the
other. We do not dispose from other data (bronchoalveolar
lavage. . .). Initially, the clinical situation and infiltrates had
complete remission with 15 mg per day of corticosteroids (CS).
He remained asymptomatic for a long period of time (several
months to a year). However, the time he remained free of infil-
trates shortened and required increasing doses of cortisone
up to 30 mg per day. Subsequently the patient could not dis-
continue corticosteroid use because his respiratory condition
worsened during the periods free of infiltrates. He became CS-
resistant in 2011 requiring 15 mg per day minimum. During
this time, he required hospitalization for some of the recur-
rences (2002, 2004(x2), 2008, 2011). For every hospitalization,
https://doi.org/10.1016/j.htct.2019.06.003
2531-1379/© 2019 Associac ¸˜ ao Brasileira de Hematologia, Hemoterapia e Terapia Celular. Published by Elsevier Editora Ltda. This is an
open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).