[Relationship between two types of organization in idiopathic organizing pneumonia and their clinical features]

Idiopathic organizing pneumonia (OP) was classified pathologically into two types, and the clinical profiles were compared. Cases in which fibrin in Masson bodies, alpha-sm-actin and m-actin antibodies were negative were regarded as type I (14 cases), and those in which they were positive as type II (7 cases). No significant differences in age and sex were observed between the two groups. As to clinical symptoms and laboratory findings, dyspnea and CRP positivity were observed more frequently and inflammatory reactions were stronger, in type II than in type I. The two groups could not be distinguished by chest X-ray findings. With regard to treatments and outcome, chest X-ray shadows disappeared completely after steroid therapy in type I, and no deaths occurred despite recurrence in some cases. In type II, chest X-ray shadows partially remained in all cases even after steroid therapy, recurrence was rare, and death occurred in some cases due to exacerbations of the initial episode. These observations suggest that there are two pathological types of OP and that the differences in clinical symptoms, laboratory findings, treatments, and prognosis between the two types must be taken into consideration in treating OP.