Utility of high-resolution computed tomography and BAL in cryptogenic organizing pneumonia

Jara‐Palomares, Luis; Gómez-Izquierdo, Lourdes; Gonzalez-Vergara, Demetrio; Rodríguez-Becerra, Eulogio; Márquez-Martín, Eduardo; Barrot‐Cortés, Emilia; Martín-Juan, José

doi:10.1016/j.rmed.2010.06.008

Cited by 25 publications

(13 citation statements)

References 23 publications

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“…When the results were discordant, the investigators met as a group to reach consensus on the specific abnormality present. Radiographical features associated with each OP case were recorded, including location of the abnormality(s) (central, peripheral or diffuse), and the presence or absence of specific changes associated with OP as described in the medical literature, including any nodule/mass,11 consolidation,12 13 ground-glass component13 and air bronchograms 14. A pulmonary nodule or mass was defined as a radiographically distinct solid lesion surrounded on all sides by pulmonary parenchyma.…”

Section: Methodsmentioning

confidence: 99%

A comparison of the pathological, clinical and radiographical, features of cryptogenic organising pneumonia, acute fibrinous and organising pneumonia and granulomatous organising pneumonia

et al. 2015

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Section: Methodsmentioning

confidence: 99%

A comparison of the pathological, clinical and radiographical, features of cryptogenic organising pneumonia, acute fibrinous and organising pneumonia and granulomatous organising pneumonia

et al. 2015

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“…The BAL differential cell count typically demonstrates a mixed pattern, consisting in increased percentage of lymphocytes (20 to 40%), neutrophils ($10%), and possibly eosinophils ($5%). 4,45,48,[90][91][92][93][94] The percentage of lymphocytes is usually higher than that of eosinophils in patients with COP but may be higher in cases overlapping with CEP. 5,47,49,83,95 The presence of a small percentage of plasma cells or especially mast cells is remarkable.…”

Section: Biological Featuresmentioning

confidence: 99%

Cryptogenic Organizing Pneumonia

Cottin

Cordier

2012

Semin Respir Crit Care Med

141

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Organizing pneumonia (OP) is a pathological pattern defined by the characteristic presence of buds of granulation tissue within the lumen of distal pulmonary airspaces consisting of fibroblasts and myofibroblasts intermixed with loose connective matrix. This pattern is the hallmark of a clinical pathological entity, namely cryptogenic organizing pneumonia (COP) when no cause or etiologic context is found. The process of intraalveolar organization results from a sequence of alveolar injury, alveolar deposition of fibrin, and colonization of fibrin with proliferating fibroblasts. A tremendous challenge for research is represented by the analysis of features that differentiate the reversible process of OP from that of fibroblastic foci driving irreversible fibrosis in usual interstitial pneumonia because they may determine the different outcomes of COP and idiopathic pulmonary fibrosis (IPF), respectively. Three main imaging patterns of COP have been described: (1) multiple patchy alveolar opacities (typical pattern), (2) solitary focal nodule or mass (focal pattern), and (3) diffuse infiltrative opacities, although several other uncommon patterns have been reported, especially the reversed halo sign (atoll sign). Definitive diagnosis is based on (1) a suggestive clinical radiological presentation, (2) the demonstration of the characteristic pathological pattern at lung histopathology, and (3) exclusion of possible causes. Transbronchial biopsies or a transthoracic biopsy may also contribute to the pathological diagnosis. Rapid clinical and imaging improvement is obtained with corticosteroid therapy. Because of the risk of misdiagnosing alternative conditions that may mimic OP, only typical cases may be managed without histopathological confirmation, and patients should be followed with particular attention paid to any clue of alternate diagnosis, especially in case of incomplete response to treatment. Patients and clinicians must be aware of frequent relapses after stopping corticosteroid treatment.

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“…We congratulate Dr. Jara-Palomares et al 1 for their elegant and important study, which discusses the utility of highresolution computed tomography (HRCT) and bronchoalveolar lavage (BAL) in the diagnosis of cryptogenic organizing pneumonia (COP). They concluded that the association of the imaging findings and BAL could be useful for diagnosing COP in patients with appropriate clinical presentation, and for those whose transbronchial biopsy is negative or for whom a confirmatory biopsy cannot be performed.…”

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confidence: 99%

Optimizing the utility of high-resolution computed tomography in diagnosing cryptogenic organizing pneumonia

Marchiori

Meirelles

Zanetti³

et al. 2011

Respiratory Medicine

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Utility of high-resolution computed tomography and BAL in cryptogenic organizing pneumonia

Abstract: The imaging findings and BAL could be useful for patients with appropriate clinical presentation and for those whose transbronchial biopsy is negative or for whom a confirmatory biopsy cannot be performed.

Cited by 25 publications

References 23 publications

A comparison of the pathological, clinical and radiographical, features of cryptogenic organising pneumonia, acute fibrinous and organising pneumonia and granulomatous organising pneumonia

A comparison of the pathological, clinical and radiographical, features of cryptogenic organising pneumonia, acute fibrinous and organising pneumonia and granulomatous organising pneumonia

Cryptogenic Organizing Pneumonia

Optimizing the utility of high-resolution computed tomography in diagnosing cryptogenic organizing pneumonia

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