Cryptogenic organizing pneumonia: clinical and radiological features, treatment outcomes of 17 patients, and review of the literature

Abstract

Background/aim: We evaluated patients with cryptogenic organizing pneumonia (COP) who attended our clinic. Materials and methods:We retrospectively investigated the clinical and radiological findings, diagnostic methods, treatment, and follow-up outcomes of 17 patients who had been histopathologically diagnosed with COP. Results:The mean age of the patients was 49.8 ± 10.4 years. The most common symptom was cough (n = 15; 88.2%) and the most common radiological finding (n = 10) was consolidation in the inferior lobes on thoracic computed tomography. The diagnosis of COP was made by open lung biopsy in 11 (64.7%) patients, transbronchial biopsy in 5 (29.4%), and video-assisted thoracoscopic surgery biopsy in 1 (5.9%). The mean follow-up period was 28.7 ± 25.0 (range: 3-85) months. Twelve patients received oral corticosteroid therapy and seven of them improved without any fibrotic changes. One patient refused treatment; a chest radiography of that patient was found to be normal at the end of the 20-month follow-up period. Three patients received no other therapy, as the lesion had been completely excised. Conclusion:Common symptoms included cough and dyspnea, while the main radiological presentation of COP was consolidation. Corticosteroids are a good treatment option in general, but relapse may occur.

Cryptogenic Organizing Pneumonia: Evolution of Morphological Patterns Assessed by HRCT

“…In our study, the mean age of onset was 58 years, and patients were aged between 25 and 84 years; a predominance in women (68%) was observed. These data are in line with the study of Niksarlioglu et al [38] and the study of Lee et al [39]. COP is usually a no smoke-related disease; our results confirm this data, as seen also in Niksarlioglu's and Lee's studies, with only five patients currently or ex-smokers (80.8% non-smokers).…”

“…These results are in line with previous papers published by Faria et al (who reported typical pattern in 83% patients) [41] and by Lee et al (who reported typical pattern in 77% patients) [39]. The second most prevalent radiological pattern was represented by GGOs; in our study, we observed GGOs in 68.1% of patients, unlike what has been reported in previous studies about this subject, where patients have shown GGOs in a range between 86% and 89% [36,38]. The atoll sign was found in four patients (18.1%), similar to the description of Kim et al in their study of 2003 [29].…”

“…A total of 21 of 22 patients received OCS therapy, with following improvement in clinical findings. Two patients (9.1%) had significant relapse after reducing/interrupting therapy, and this behavior respects what was already reported in previous articles [38,39].…”

“…. ) and an obstructive pattern was determined in one patient who was a smoker" [38]; however, in our study, we did not observe any obstructive pattern.…”

“…In comparison to Sveinsson's study of 2007 [40], where fever was present in 50% of patients, in our study, only 13.6% of patients complained this symptom. In Niksarlioglu et al's study, cough was the most common symptom (88.2% of patients), while 54.5% of our patients experienced cough (in the majority of case it was dry cough) [38].…”