Clinical Manifestations Of 7Cryptogenic Organizing Pneumonia

BACKGROUNDCryptogenic organizing pneumonia is an organizing pneumonia of unknown cause, included in the classification of IIP and with distinctive clinical, radiological and pathological features. Cryptogenic organizing pneumonia with low incidence and nonspecific clinical manifestations is often misdiagnosed or missed. However, rapid clinical and imaging improvement is obtained with corticosteroid treatment. So improving the diagnosis of cryptogenic organizing pneumonia, avoiding misdiagnose and missing diagnosis and reducing the period of diagnosis, is a significance.OBJECTIVETo analyze the clinical,radiological,pathological features of cryptogenic organizing pneumonia.METHODSA survey was conducted on 7 cryptogenic organizing pneumonia who were hospitalized in Fujian Provincial Hospital between January of 2007 and December of 2009.Then a retrospective analysis was performed on the clinical manifestations, physical examination records, lab tests results , images, pathological characteristics treatment logs and prognosis of these patients.RESULTSThere were 5 females and 2 males,with a mean age of 57.43±12.59 years. The presentations included mild cough,clear sputum , dyspnea and fever. Since the most common manifestations were nonspecific, diagnosis was usually delayed (64.71±23.81days) with misuse of antibiotics. None of them had dust inhalation, 85.8% were nonsmokers. The three main characteristic imaging patterns of cryptogenic organizing pneumonia consisted of multiple alveolar opacities, solitary opacity and infiltrative opacities, and the multiple alveola opacities were often migratory. A mild restrictive ventilator defect was the most common abnormality in lung function test, and hypoxaemia at rest is usually mild. The C-reactive Protein level and erythrocyte sedimentation rate were increased. The Pathological characteristic was intra-alveolar buds of granulation tissue, consisting of intermixed myofibroblasts and connective tissue. Corticosteroid treatment in COP resulted in rapid clinical improvement and clearing of the opacities on chest imaging without significant sequelae. However, relapses were common upon stopping or reduction of corticosteroids.CONCLUSIONSThe clinical-radiological-pathological diagnosis is the most important diagnostic method. The diagnosis of COP requires the exclusion of any possible cause. Corticosteroid treatment in COP results in rapid clinical improvement and clearing of the opacities on chest imaging. But relapses were common upon stopping or reduction of corticosteroids.