Cryptogenic Organizing Pneumonia:Three Case Reports And Literature Review

Objective:To improve the identification of cryptogenic organizing pneumonia (COP) by reporting three cases and analyzing the clinical characteristics, radiological and pathological features, diagnosis and treatment of25Chinese COP patients reported in literatureMethods:Report3cases of COP confirmed by biopsy in Second Hospital Affiliated to Zhejiang University.Twenty-five COP cases reported in mainland China from2006to2015were analyzed as well.Results:We analyzed25cases diagnosed with COP confirmed by lung biopsies. There were13males and12females, with a mean age of54.2years(range30-79years). Clinical manifestations were nonspecific. Majority of the patients were presented with cough, sputum production, dyspnea and fever. Some of them had hemoptysis, chest pain, malaise, anorexia, weight loss and night sweats. Crackles, especially "Velcro" crackles could be found in some patients. Lung function tests showed a mild to moderate restrictive ventilatory pattern and reduced diffused function. Hypoxemia was usually mild, while severe hypoxemia may be present in rapidly progressive forms of COP. Elevation of erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) serum level was common. Multiple patchy alveolar opacities and consolidation were the main imaging patterns in HRCT. Corticosteroid treatment resulted in rapid clinical improvement in COP cases.Conclusion:COP result in good prognosis if it is administrated in time. Corticosteroid treatment represents the standard therapy in COP. However patients were often misdiagnosed. Clinical-radiological-pathological is the most important diagnostic method.