Organizing pneumonia: chest HRCT findings

Abstract

OBJECTIVE: To determine the frequency of HRCT findings and their distribution in the lung parenchyma of patients with organizing pneumonia. METHODS: This was a retrospective review of the HRCT scans of 36 adult patients (26 females and 10 males) with biopsy-proven organizing pneumonia. The patients were between 19 and 82 years of age (mean age, 56.2 years). The HRCT images were evaluated by two independent observers, discordant interpretations being resolved by consensus. RESULTS: The most common HRCT finding was that of ground-glass opacities, which were seen in 88.9% of the cases. The second most common finding was consolidation (in 83.3% of cases), followed by peribronchovascular opacities (in 52.8%), reticulation (in 38.9%), bronchiectasis (in 33.3%), interstitial nodules (in 27.8%), interlobular septal thickening (in 27.8%), perilobular pattern (in 22.2%), the reversed halo sign (in 16.7%), airspace nodules (in 11.1%), and the halo sign (in 8.3%). The lesions were predominantly bilateral, the middle and lower lung fields being the areas most commonly affected. CONCLUSIONS: Ground-glass opacities and consolidation were the most common findings, with a predominantly random distribution, although they were more common in the middle and lower thirds of the lungs.

‘Crazy-paving’ pattern: an exceptional presentation of cryptogenic organising pneumonia associated with chronic obstructive pulmonary disease

“…Five major radiological series5 16–19 have highlighted three characteristic radiological patterns with multiple areas of patchy consolidation—often migratory—being the most common presentations. These areas of consolidation correspond to the granulation tissue plugs within the alveoli.…”

“…None of the patients had a diagnosis of COP. In a review of five radiological series documenting 153 patients with OP/COP, a ‘Crazy-paving’ pattern was not reported in any patient 5 16–19…”

“…Secondary OP may be caused by infections, drugs, radiation therapy, connective tissue disorders, collagen vascular disease, malignancies and organ transplantation 1–3. In the majority of patients, the cause of OP is unknown4 5 and this group is known as having ‘cryptogenic OP (COP)’, a term coined by Davison et al ,6 in 1983. COP has been included as one of the idiopathic interstitial pneumonias (IIP) in the classification of major IIPs by the American Thoracic Society and European Respiratory Society 7.…”

Neumonía organizativa criptogénica

“…La mayoría son periféricas y exhiben patrón migratorio; el broncograma aéreo es visible a través de la consolidación, mientras que el volumen pulmonar se conserva (19).…”

A Case of Cryptogenic Organizing Pneumonia Managed without a Diagnostic Biopsy

“…4 Diagnosis is made via biopsy; though surgical biopsy via thoracoscopy has remained the gold standard, trans-bronchial biopsy has recently gained prevalence. 5 We aim to present a suspected case of COP as an uncommon cause of interstitial lung disease.…”