隐原性机化性肺炎的临床、病理和影像学诊断

Radiographic diagnosis of cryptogenic organizing pneumonia with clinical and histological correlation

在美国,现在认为隐原性机化性肺炎(COP)是替代闭塞性细支气管炎伴机化性肺炎(BOOP)的更好的术语。COP是罕见的独立的疾病实体,现包括在特发性间质性肺炎之中。其重要的病理特征为肺泡内和小气道管腔内有疏松的纤维状的息肉样的肉芽组织。主要的临床表现有呼吸困难和咳嗽;典型的胸部X线表现是多发的,双侧肺分布或局灶实变影;胸部CT主要表现为位于支气管血管束周围或胸膜下实变影或不规则形条索影。肾上腺皮质激素治疗效果显著。

Cryptogenic organizing pneumonia (COP) is now considered the preferred term even in the United States for idiopathic bronchiolitis obliterans organizing pneumonia. COP is a rare, distinct disorder that included idiopathic interstitial pneumonias. The main histopathologic feature of organizing pneumonia is the presence of polypoid plugs of loose fibroblastic tissue within alveoli and distal small airways. In its most typical presentation, it is characterized by dyspnea and cough. The typical radiographic appearances of COP are multiple, usually bilateral, foci of consolidation. The most common CT finding of COP has been reported to be bilateral patchy areas of air-space consolidation that show predominantly subpleural or peribronchovascular distribution, and linear or band-like opacitie. Corticosteroid treatment is rapidly effective.