Muhammet Fırat Öztepe, Kemal Buğra Memiş, Tunç Batuhan Acar
Advanced Radiology and Imaging - 2025;2(3):63-66
Objectives: Organizing pneumonia (OP) is a non-specific clinicopathological entity that may mimic pulmonary malignancy and can coexist with primary or metastatic lung cancer. This study aimed to evaluate the clinical and radiological characteristics of patients initially diagnosed with OP on computed tomography (CT)-guided lung biopsy who were subsequently found to have underlying malignancy on repeat biopsy. Methods: This retrospective study included 151 patients who underwent CT-guided lung biopsy for suspected primary or metastatic lung cancer. The study group comprised twelve patients (7.9%) whose initial biopsy results were reported as OP . Patients with persistent clinical or radiological suspicion of malignancy underwent repeat biopsy. Clinical risk factors and thoracic CT features associated with malignancy were evaluated and correlated with final pathological outcomes. Results: Among the 12 patients diagnosed with OP on initial biopsy, 6 underwent repeat biopsy due to ongoing suspicion of malignancy. Underlying malignancy was confirmed in 5 of these patients (41.6% of the study group): three cases of primary lung cancer and two cases of metastatic malignancy. Key indicators prompting repeat biopsy included lesion progression, lack of response to treatment, history of malignancy, and technically inadequate initial biopsy. No progression was observed in patients managed with clinical and radiological follow-up alone. Conclusion: OP and malignancy may coexist and share overlapping imaging features. In patients with OP who demonstrate lesion progression, treatment resistance, or persistent clinical or radiological suspicion of malignancy, repeat biopsy should be strongly considered to avoid delayed cancer diagnosis.
