Abstract
A 65-year-old female was hospitalized on July 27, 1987 because of fever and malaise of one month's duration, which had failed to respond to treatment with any antibiotics. On admission the physical examination revealed diffuse goiter and small bubbling rales in her right upper field. The chest roentogenogram showed a right upper infiltrative shadow with pleural effusion and later extension to bilateral lower fields. Pathological examination of all material obtained by 3 transbronchial lung biopsy (TBLB) procedures, organizing inflammatory exudates in the alveolar ducts and alveoli and alveolitis were seen. Although bronchiolitis obliterans could not be demonstrated in TBLB specimens, cryptogenic organizing pneumonia and/or bronchiolitis obliterans organizing pneumonia (BOOP) was suspected and treatment with steroids (prednisolone 40mg) was commenced. There was dramatic response and the patient almost immediately afibrile. One month later, the lung infiltrates had cleared. These clinical findings and the histology of TBLB specimens suggested this was a case of BOOP.
