Tennessee Medicine E-Journal


A 70-year-old male with medical history of chronic bronchitis, obstructive sleep apnea, atrial fibrillation, remote 40 pack year smoker but no occupational exposure presented with gradual onset of dry cough, dyspnea on exertion and fatigue. His symptoms had been worsening over the course of 1 year. On physical exam, he was noted to have decreased breath sounds diffusely & bibasilar rales. CT chest showed extensive ground-glass opacities throughout the lower lobes, inferior half of right upper lobe and right middle lobe. A trial of antibiotics failed and his pulmonary function test showed a restrictive pattern. Infectious, neoplastic and connective tissue disorders were ruled out systematically. Ultimately wedge resection with histology revealed evidence of organizing pneumonia. Patient was on simvastatin which was stopped and he was noted to have clinical and radiological improvement on follow up visit.