Cryptogenic Organizing Pneumonia: A Clinical And Radiological Data Analysis Of 32 Cases

Objective: To describe the clinical and imaging feature from 32 cases of Cryptogenic Organizing Pneumonia(COP)and review the related literature so as to improve the clinicians understanding of the disease.Methods: General Information,laboratory examination,pulmonary function and arterial blood gas analysis,clinical manifestations and radiographic features of 32 patients with pathology-proven diagnosis of COP from December 2012 ~ December2015 were extracted and retrospectively analyzed.Results: Of the 32 patients,21 were male and 11 were female.The mean age of COP was 46 to 75 years.4 cases(12.5%)had smoking history.The most common clinical symptom was expectoration(53.1%),followed by dyspnea(25.0%),chest pain(25.0%),dry cough(21.9%),hemoptysis(21.9%),Weight loss(15.6%),fever(12.5%),Night sweats(12.5%)or weak(9.4%).Blood leukocyte levels were mostly normal(87.5%),but the vast majority of patients showed accelerated erythrocyte sedimentation rate(94.1%)and elevated C-reactive protein(86.7%).The most patients had mild restrictive ventilatory dysfunction.Hypoxaemia was usually mild in some patients.The most frequent feature in thoracic CT was ground-glass opacification(68.8%),followed by consolidation(40.6%)and space occupying lesions(31.3%),respectively,others present with nodules,peribronchovascular opacities,cavitary lesion,honeycombing or pleural effusion,respectively.Of the 17 cases of nodular and mass-type cryptogenic organizing pneumonia(NMCOP),11 were male and 6 were female.The mean age of NMCOP was 47 to 66 years.28.6% cases(4 of 17)had smoking history.The most common clinical symptom was Cough and expectoration(70.6%),followed by chest pain(23.5%)and hemoptysis(23.5%).With regard to CT performance,polygonal mass with irregular margins were seen in 64.7%(11 of 17),focal round or oval mass-like opacities were found in 35.3%(6 of 17),12 cases as fuzzy border,5 as clear boundary,5 as shallow lobulations,2 as deep lobulations,2 as long spiculations,1 as short spiculations,2 as vessel convergence,6 as spinous processes,and only 1 had fat gap in 6 cases of Lesions spread to the pleura.Conclusion: The diagnosis of COP depends on pathological diagnosis,Comprehensive analysis of clinical data and chest imaging findings in patients is helpful to the early diagnosis of COP,and can avoid delay treatment.