Ct scan of the chest in case Cryptogenic Organizing Pneumonia

• Non-specific inflammatory response

• Pattern of repair

• Self-perpetuating

• Cryptogenic

• Secondary: Connective tissues disease, hematologic malignancy, drugs or organ transplantation

• Focal : Bacteria, legionella, mycoplasma, mycobacterial, or infarction

Lohr, Arch Int Med 1997

Cryptogenic Organizing Pneumonia

• Terminology problem: Bronchiolitis obliterans OP (BOOP), bronchiolitis obliterans (BO), bronchiolitis interstitial pneumonia (BIP)

• Subacute presentation (3 months)

• M=F

• Cough, dyspnea, weight loss, fever

• Restrictive PFT’s

• Steroid responsive

• Relapse common

(Epler, NEJM 1985)

Cryptogenic Organizing Pneumonia Histology

• Fibroblastic plugs in alveoli

• Fibrosis in the alveolar space

• May be airway centered : Bronchiolitis

Cryptogenic Organizing Pneumonia Radiography

• Consolidation: Unlateral or bilateral

• Small Nodules:10-50%

• Lung volumes: normal in 75%

ct scan of the chest Cryptogenic Organizing Pneumonia

• Consolidation 90%

• Ground glass 75%

• Bronchial thickening and dilatation

• Small nodules along bronchvascular bundles

• Large nodules (15%): Irregular margins, Air bronchograms

• Reverse halo

clip_image002

Ct scan of the chest Typical findings in COP with peripheral areas of consolidation. The differential includes chronic eosinophilic pneumonia, bronchoalveolar cell carcinoma, lymphoma and infection

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