Multifocal Pulmonary Opacities in an Elderly Smoker

Organizing pneumonia (OP) directly caused by ongoing cigarette smoking does not appear to have been previously described. Despite OP having pathophysiological features distinct from lung cancer, the two may be confused based on similar clinical, radiological, and histopathological findings. This distinction is further clouded by the dynamic nature of these diseases. Diagnostic accuracy can likely be improved with a multidisciplinary approach that involves input from several specialists and serial reevaluations as the disease evolves. We present a case of OP that was initially misdiagnosed as non-small-cell lung cancer and resolved with smoking cessation.