Amiodarone‐Induced Pneumonia Without Foamy Macrophages in the BALF : A Diagnostic Challenge Unveiled by Cryobiopsy

Respirology Case Reports 2026 Open access

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Authors: Tomo Tsunoda, Kazuo Tsuchiya, Yoshiyuki Oyama, Shusuke Yazawa, Ryota Miyamoto, Taisuke Ito, Takuro Akashi, Noriyuki Enomoto, Tomoyuki Fujisawa, Masaki Ikeda, T SUDA
DOI: 10.1002/rcr2.70503
Cited by: 1
References: 5

Abstract

A 64-year-old man with a mild cough presented with abnormal chest imaging with centrilobular ground-glass opacities in the upper lobes, peribronchovascular and subpleural consolidation and small nodules. Bronchoalveolar lavage fluid (BALF) lacked foamy macrophages, transbronchial lung cryobiopsy revealed features consistent with amiodarone-induced interstitial pneumonia, including vacuolization of type II alveolar epithelial cells, lymphoid follicle formation and granulation tissue. After discontinuation of amiodarone, the patient's symptoms and radiographic abnormalities improved. This case highlights that the absence of foamy macrophages in BALF should not preclude amiodarone-induced pneumonia, and that histological evaluation plays a pivotal role in establishing an accurate diagnosis.

Fields of Study & Subjects

Interstitial Lung Diseases and Idiopathic Pulmonary Fibrosis Pleural and Pulmonary Diseases Respiratory and Cough-Related Research

Publication details

Journal / source
Respirology Case Reports
Publisher
Wiley
Volume
14
Issue
2
Pages
e70503–e70503
Publication date
1 February 2026
Language
EN