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Lee, Park, Son, Jung, Hwang, Chon, Kim, Lim, Lee, Yoon, Kim, Kim, Chang, Shim, Cho, and Park: A Case of Bronchilolitis Obliterans Organizing Pneumonia in a Patient with Ulcerative Colitis
Case Report
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2010; 68(3): 175-179.

Published online: 31 March 2010

DOI: https://doi.org/10.4046/trd.2010.68.3.175

A Case of Bronchilolitis Obliterans Organizing Pneumonia in a Patient with Ulcerative Colitis

Hyun Jung Lee, M.D.1, Byung Hoon Park, M.D.1, Ji-Young Son, M.D.1, Ji Ye Jung, M.D.1, Sena Hwang, M.D.1, Young Eun Chon, M.D.1, Eun Young Kim, M.D.1, Ju Eun Lim, M.D.1, Kyung Jong Lee, M.D.1, Yoe Wun Yoon, M.D.1, Young Sam Kim, M.D.1, 2, Se Kyu Kim, M.D.1, 2, Joon Chang, M.D.1, 2, Hyo Sub Shim, M.D.3, Sang Ho Cho, M.D., Ph.D.4, Moo Suk Park, M.D.1, 2

1Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.

2The Institute of Chest Diseases, Yonsei University College of Medicine, Seoul, Korea.

3Department of Pathology, Yonsei University College of Medicine, Seoul, Korea.

4Department of Pathology, Bundang CHA Hospital, CHA University College of Medicine, Seongnam, Korea.

Address for correspondence: Moo Suk Park, M.D. Department of Internal Medicine, Yonsei University College of Medicine, 134, Shinchon-dong, Seodaemun-gu, Seoul 120-752, Korea. Phone: 82-2-2228-1974, Fax: 82-2-393-6884, pms70@yuhs.ac

Received 30 September 2009       Accepted 13 November 2009

Copyright © 2010. The Korean Academy of Tuberculosis and Respiratory Diseases. All rights reserved.

Abstract

The ulcerative colitis is a chronic inflammatory bowel disease with an unknown etiology. The major symptoms of ulcerative colitis are diarrhea, abdominal pain and hematochezia. However, arthritis, skin disorders, hepatobiliary inflammation and uveitis are occasionally recognized as systemic complications. Although there are few reports of coexistent pulmonary and inflammatory bowel disease, the lung is not generally considered to be a target organ in ulcerative colitis. We report a patient with ulcerative colitis-related bronchilolitis obliterans organizing pneumonia confirmed by video-assisted thoracoscopic surgery, who responded to corticosteroid therapy.

Keywords: Colitis, Ulcerative, Lung, Cryptogenic Organizing Pneumonia

Figures and Tables

Figure 1
Initial Chest PA showed slightly increased reticular pattern in both lower lobes.
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Figure 2
High resolution computed tomography (HRCT) at initial diagnosis showed irregular shaped nodules, air trapping, and bronchiectasia on both lower lobes (A, B). HRCT obtained after 3 months treatment on same level demonstrated improvement of previous noted lesions (C, D).
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Figure 3
The histologic finding of the wedge resected lung tissue showed organizing fibrosis that predominantly involved bronchiolar lumens and peribronchiolar airspaces (A, H&E stain, ×100). The fibrosis was composed of elongated fibroblasts and chronic inflammatory cells embedded in a myxoid stroma (B, H&E stain, ×400).
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