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Ann Thorac Surg 2007;83:1946-1951
© 2007 The Society of Thoracic Surgeons

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Original Articles: General Thoracic

Localized Organizing Pneumonia: Report of 21 Cases

^a Department of Thoracic Surgery, San Raffaele Scientific Institute, Milan, Italy
^b Department of Respiratory Medicine, San Raffaele Scientific Institute, Milan, Italy
^c Department of Pathology, San Raffaele Scientific Institute, Milan, Italy
^d Department of Radiology, San Raffaele Scientific Institute, Milan, Italy
^e Department of Thoracic Surgery, Carlo Poma Hospital, Mantua, Italy

Accepted for publication January 29, 2007.

^_* Address correspondence to Dr Melloni, Unità Operativa di Chirurgia Toracica, Ospedale San Raffaele, Via Olgettina, 60, Milan, 20132, Italy (Email: giulio.melloni{at}hsr.it).

Background: Thoracic surgeons have limited experience with treating localized organizing pneumonia owing to its rare occurrence in routine clinical practice.

Methods: We retrospectively investigated the clinicopathologic features of 21 patients with localized organizing pneumonia observed between 2001 and 2004.

Results: There were 15 men and 6 women. Mean age was 63 years. Eight patients (38%) were symptomatic. Computed tomographic scan showed a single lesion in 17 patients (12 nodules and 5 masses) and bilateral lesions in 4. Wedge resection was performed in 16 patients and lobectomy in 5. There was no operative mortality. Follow-up was complete in all patients (range, 2 to 46 months; median, 20 months). Surgery was curative in 15 of 17 patients with a single lesion, and no recurrence was observed (p < 0.005). The remaining 2 patients with a single lesion (2 masses) had a local relapse with the appearance of nodular lesions in the residual parenchyma. Both these patients received steroids with resolution of the lesions. All 4 patients with bilateral lesions who underwent surgery for diagnostic purposes received steroids with improvement of the radiologic aspect in 3 and stabilization of the lesions in 1.

Conclusions: Clinical and radiologic findings of localized organizing pneumonia are nonspecific, and this unusual entity is difficult to differentiate from a primary or metastatic tumor. Surgical resection allows both diagnosis and cure. However, considering the benignity of the lesion and the efficacy of steroids, major pulmonary resections should be avoided.

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