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Updated: Mar 26, 2026
Lung CT Segmentation to Identify Consolidations and Ground Glass Areas for Quantitative Assesment of SARS-CoV Pneumonia
Published on: December 19, 2020
[Cryptogenic organizing pneumonia]
N Petitpierre1, C Beigelman2, I Letovanec3
1Unité des pneumopathies interstitielles et maladies pulmonaires rares, service de pneumologie, centre hospitalier universitaire vaudois (CHUV), 46, rue du Bugnon, 1011 Lausanne, Suisse.
Introduction:
Organizing pneumonia is a particular type of inflammatory reaction of the lung which gives rise to a clinico-pathological syndrome. It is called "secondary" when a cause such as an infection, a drug toxicity, or a connective tissue disease can be identified, or "cryptogenic" when no cause is identified. The clinical picture is usually characterized by the subacute onset of fever, fatigue, cough and dyspnea, with multiple subpleural areas of consolidation on thoracic imaging.
State Of The Art:
Organizing pneumonia is characterised by the presence of buds of endoalveolar connective tissue. These result from an injury to the alveolar epithelium, followed by the deposition of fibrin in the alveolar spaces, and the migration of fibroblasts which produce a myxoid endoalveolar matrix. A remarkable feature of organizing pneumonia is the complete disappearance of these endoalveolar buds with corticosteroid treatment, in sharp contrast with what is seen in pulmonary fibrosis. The clinical response to corticosteroids is usually prompt and excellent. Relapses are frequent but usually benign.
Perspectives And Conclusion:
As the clinical, imaging and pathological characteristics of organizing pneumonia are now well established, many questions remain unanswered, such as the mechanisms involved in the complete reversibility of the pulmonary lesions, and the role of steroid-sparing treatments such as immunomodulatory macrolides.
Insights
Organizing pneumonia, an inflammatory lung condition, shows characteristic endoalveolar connective tissue buds. Corticosteroid treatment leads to complete lesion disappearance, though relapses can occur.
Area of Science:
- Pulmonology
- Pathology
- Rheumatology
Background:
- Organizing pneumonia is an inflammatory lung syndrome with identifiable (secondary) or unknown (cryptogenic) causes.
- Clinical presentation typically includes subacute fever, fatigue, cough, dyspnea, and imaging-confirmed consolidation.
- Pathologically, it features endoalveolar connective tissue buds resulting from alveolar injury.
Purpose of the Study:
- To elucidate the clinico-pathological characteristics of organizing pneumonia.
- To highlight the unique reversibility of lesions with corticosteroid therapy.
- To identify areas for future research, including treatment mechanisms and steroid-sparing options.
Main Methods:
- Review of clinical, imaging, and pathological features of organizing pneumonia.
- Analysis of the response to corticosteroid treatment.
- Identification of key pathological hallmarks, such as endoalveolar connective tissue buds.
Main Results:
- Organizing pneumonia presents with characteristic subacute symptoms and imaging findings.
- The condition is marked by endoalveolar connective tissue buds, a distinct pathological feature.
- Corticosteroid treatment demonstrates remarkable efficacy, leading to complete resolution of lesions, contrasting with pulmonary fibrosis.
Conclusions:
- The clinical, imaging, and pathological aspects of organizing pneumonia are well-defined.
- The mechanisms behind the complete reversibility of pulmonary lesions require further investigation.
- The role of alternative treatments, such as immunomodulatory macrolides, warrants exploration.
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