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Cryptogenic organising pneumonia — SCE Respiratory MCQ

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ModerateInterstitial lung diseaseCryptogenic organising pneumoniaSCE Respiratory

A 55-year-old woman develops cough, fever and weight loss six weeks after a viral illness. Chest radiograph shows bilateral patchy peripheral consolidation that migrates on repeat imaging. Blood eosinophils are normal, sputum cultures are negative and HRCT shows perilobular consolidation. She has no asthma history and no drug trigger is identified. What is the most likely diagnosis?

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Correct answer: C — Cryptogenic organising pneumonia

Migratory peripheral consolidation with systemic symptoms and negative cultures is typical of organising pneumonia. Chronic eosinophilic pneumonia can look peripheral, but normal eosinophils and perilobular change make it less likely. Steroid responsiveness is common, but relapse can occur during tapering.

Reference: BTS ILD resources; ERS statement on interstitial pneumonias