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Cryptogenic organizing pneumonia

Vincent Cottin1, Jean-François Cordier

  • 1Hospices Civils de Lyon, Louis Pradel Hospital, National Reference Centre for Rare Pulmonary Diseases, Department of Respiratory Medicine, University Claude Bernard Lyon I, University of Lyon, Lyon, France. vincent.cottin@chu-lyon.fr

Seminars in Respiratory and Critical Care Medicine
|September 25, 2012
PubMed

Insights

Organizing pneumonia (OP) is a lung disease characterized by granulation tissue in airspaces. Differentiating OP from fibrosis is key, as cryptogenic organizing pneumonia (COP) often responds well to corticosteroids, though relapses can occur.

Area of Science:

  • Pulmonology
  • Pathology
  • Radiology

Background:

  • Organizing pneumonia (OP) is a pathological pattern involving granulation tissue in pulmonary airspaces.
  • Cryptogenic organizing pneumonia (COP) is diagnosed when no cause for OP is identified.
  • OP involves alveolar injury, fibrin deposition, and fibroblast proliferation.

Purpose of the Study:

  • To analyze features differentiating reversible OP from irreversible fibrotic processes.
  • To understand the distinct outcomes of COP versus idiopathic pulmonary fibrosis (IPF).
  • To review the diagnostic imaging patterns and therapeutic approaches for COP.

Main Methods:

  • Review of characteristic pathological patterns of OP.
  • Analysis of three main imaging patterns of COP: typical, focal, and diffuse infiltrative.
  • Consideration of histopathological confirmation and exclusion of other causes for diagnosis.

Main Results:

  • COP diagnosis relies on clinical presentation, characteristic pathology, and exclusion of causes.
  • Common imaging patterns include patchy opacities, focal masses, and diffuse infiltrates; the reversed halo sign is also noted.
  • Corticosteroid therapy typically leads to rapid clinical and imaging improvement.

Conclusions:

  • Distinguishing OP from fibrosis is crucial for patient outcomes.
  • Typical COP cases may be managed without biopsy, but vigilance for alternative diagnoses is essential.
  • Patients require monitoring for potential relapses after corticosteroid cessation.

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