[Clinicopathologic study of cryptogenic organizing pneumonia].
OBJECTIVE
To study the clinicopathologic features and differential diagnosis of cryptogenic organizing pneumonia (COP).


METHODS
The clinical, radiologic and pathologic features of 11 patients with COP confirmed by open or video-assisted thoracoscopic (VATS) lung biopsy were analyzed. Treatment information and follow-up data were also obtained.


RESULTS
COP usually affected female patients over 40 years of age. Clinical presentations included cough, sputum and exertional dyspnea. High-resolution computerized tomography showed scattered speckled, patchy and trabecular shadows over both lung fields. Honeycomb changes were not found. Histologically, polypoid growths of granulation tissue were noted within respiratory bronchioles, small airways and alveolar spaces. These lesions had a patchy and peribronchiolar distribution and were uniform in appearance. The overall response rate to glucocorticoid was 81.8% (P < 0.01). The duration of follow up ranged from 6 to 134 months. Apart from one patient who developed aggravation of symptoms, the disease pursued a relatively stable clinical course.


CONCLUSIONS
In general, COP responds well to glucocorticoid therapy. Open or VATS lung biopsy is important for arriving at a definitive diagnosis, especially for those cases presenting with atypical clinical and radiographic manifestations. Multiple biopsies with larger samples are preferred in order to avoid misdiagnosis.
Yi
Xiang-hua
XH
Department of Pathology, Shanghai Pulmonary Hospital, Tongji University, Shanghai 200433, China. yixhxf@yahoo.com.cn
Li
Hui-ping
HP
Gao
Wen
W
Shi
Jing-yun
JY
Chen
Xiao-feng
XF
Li
Xia
X
Liu
Jin-ming
JM
Zhang
Yun
Y
D000328:Adult; D000368:Aged; D001706:Biopsy; D018549:Cryptogenic Organizing Pneumonia / Q000188:drug therapy* / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D008168:Lung / Q000187:drug effects / Q000473:pathology / Q000528:radiation effects; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use; D008875:Middle Aged; D011241:Prednisone / Q000627:therapeutic use; D013906:Thoracoscopy / Q000379:methods; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D005938:Glucocorticoids; D011241:Prednisone; D008775:Methylprednisolone