A 45-year-old woman recovering from a viral upper respiratory infection develops progressive dyspnea and cough. HRCT shows bilateral patchy consolidation with a peripheral distribution. Surgical lung biopsy shows polypoid plugs of loose connective tissue filling alveolar ducts and bronchioles. Which statement about this condition is correct?

• A It requires lifelong antifibrotic therapy with pirfenidone
• B It progresses inexorably to honeycombing despite treatment
• C It responds well to corticosteroids and may resolve completely ✓
• D It is caused by germline mutations in the TERT gene

Explanation

Cryptogenic organizing pneumonia shows Masson bodies, polypoid plugs of immature fibroblasts and myofibroblasts in a loose collagen matrix filling alveolar ducts and bronchioles, with preservation of underlying lung architecture. Unlike UIP, there is no temporal heterogeneity or honeycombing, and many patients respond dramatically to corticosteroids, though relapse can occur on withdrawal. TERT mutations relate to familial pulmonary fibrosis, not COP.

Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.