HRCT findings of cryptogenic organizing pneumonia

WU Xiaohua; MA Daqing; JIN Erhu; YUE Yunlong; HOU Xinmeng; ZHANG Shuhong

Abstract：Objective To study the HRCT findings of cryptogenic organizing pneumonia ( COP) .Methods The clinical,ra-diologic and pathologic features of 20 patients with COP confirmed by open or video-assisted thoracoscopic ( VATS) lung biopsy, trans bronchial lung biopsy ( TBLB) or percutaneous lung biopsy were analyzed.Treatment information and follow-up data were al-so obtained.Results COP usually affected female patients over 40 years of age.Clinical presentations included cough, sputum and exertional dyspnea.HRCT findings included bilaterial (14/20,70%) distributed consolidation (17/20,85%) and ground glass opacity (GGO)(7/20, 35%), nodules (8/20, 40%).The lesions were unresponsive to antibiotic, while good responsive to corticosteroid.Honeycomb changes were not found.The overall percentage of response to glucocorticoid was 100%.The dura-tion of follow up ranged from 2 to 130 months.All patients were in stable clinical course.Conclusion In general, multiple con-solidation, GGO and nodules in bilaterial lungs, subpleural or peribronchialvascular predominant distribution were typical HRCT findings of COP.Reverse halo sign was relative specific CT finding.With clinical data and typtical HRCT findings, trans bronchi-al lung biopsy ( TBLB) or percutaneous lung biopsy most COP could be diagnosed.Some cases need open or video-assisted thora-coscopic ( VATS) lung biopsy to make a definitive diagnosis.