Secondary Organizing Pneumonia (OP) due to malignancy is a condition extremely rare. We describe a case of a 36 years-old woman, who presented with right cervical lymphadenopathies and multiple nodular foci of consolidation and ground glass opacities in CT images. The cervical lymphadenopathy biopsy reveled a diffuse large B-cell lymphoma (DLBCL). PET-CT detected metabolically activity involving lymphoid tissue in the nasopharynx, cervical right lymph nodes and lung lesions (Fig. 1A). She had no respiratory symptoms. In order to confirm the initial stage of the disease, a CT-guided transthoracic tru-cut biopsy of the pulmonary lesions was performed, which revealed an organizing pneumonia (Fig. 1C).
Patient started treatment with R-CHOP chemotherapy and, after 4 cycles, reassessment images (CT and PET-CT) showed resolution of pulmonary lesions and no lymphoproliferative disease with metabolic activity (Fig. 1B). The treatment of the underlying disease resolved the secondary OP. The patient completed treatment with involved-field radiation therapy. With this report, the authors empathize the importance of clarifying the etiology of pulmonary lesions that can mimic pulmonary metastasis and change the staging of oncologic diseases.1,2
