Clinical Feature Of Crytogenic Organizing Pneumonia

Objective:Through retrospective analysis of the characteristics of pathogenesis,pathological manifestations and imaging features of Cryptogenic Organizing Pneumonia(COP)patients who were diagnosed by our hospital,that can enhances the clinician's comprehension of COP and diagnosis level of COP.It may reduce the occurrence of misdiagnosis and over-medication of COP.Methods:To collect and retrospectively analyze the General information,clinical symptoms and characteristics,initial diagnosis,laboratory findings,pathology,imaging features,treatment and outcomes of COP patients diagnosed by Soochow University No.l hospital from January 1,2008 to December 31,2018.Results:A total of 79 COP patients were enrolled,including 52 males and 27 females,with an average age of 60.32±9.56 years.The most common age distribution of patients are 50 to 70 years.The history of smoking and past history are not closely related to the incidence of COP.Cough was the most common symptom.At the same time,there could be fever,difficulty breathing,hemoptysis,chest pain and other performances.COP is often misdiagnosed as lung cancer,pneumonia and other diseases,with the use of anti-biotic is not effective.The laboratory test results show that the hypersensitivity C reflection protein(Hs-CRP)is increased.Pathology can be obtained by surgery,percutaneous lung puncture,and bronchoscopy lung biopsy(TBLB),which is characterized by the pathological features of organizing pneumonia in granulation tissue composed of fibroblast or myofibroblast mixed connective tissue in alveolar and alveolar duct.CT images are various in shape,with consolidation,mass/nodule,ground glass opacities.Multiple lesions,subpleural distribution and accompany with bronchial and vascular bundles are common.There may be the air bronchogram,pleural indentation,halo sign and reversal halo sign and lesions walking in CT.Some of severe cases can accompanied with pleural effusion and pneumothorax.Glucocorticoid treatment was effective,70 patients improved,2 patients died,and 7 patients had recurrence after treatment.Conclusions:1.Patients with COP are mainly affected by middle-aged and elderly people.There is no difference between men and women.It has nothing to do with smoking history and past history.The clinical features are not specific.There may be increased Hs-CRP and anti-biotic invalid.2.COP pathology can be obtained by TBLB,percutaneous lung puncture and surgery.The pathology conform the features of OP.3,COP patients with a variety of CT images,there may be consolidation,mass/nodule,ground glass opacities,while CT often shows air bronchogram,pleural indentation,halo sign and reversal halo sign,and lesions walking.Some of severe cases can accompanied with pleural effusion and pneumothorax.4.Glucocorticoid treatment was effective,but easier to relapse.