| Objective: This article mainly summarizes the clinical,imaging,pathology and other characteristics of cryptogenic organizing pneumonia,compared with different subtypes of cryptogenic organizing pneumonia between the clinical features,biological features and other differences,aimed at deepened cognition of the different subtypes of the disease,increases chances of misdiagnosis.Methods: The clinical manifestations,laboratory tests,radiological images,the method of obtain lung tissue and therapy for COP were analyzed retrospectively 44 cases which diagnosed by pathology from March 2012 to March 2017 in the first affiliated hospital of Guangxi Medical University.According to different subtypes and imaging characteristics of the group,compared between different subtypes in clinical manifestations,laboratory tests,the method of obtain lung tissue and other differences.Results:There were 44 patients including 26 males and 18 females with the mean age of 54.77±13.81 years old.According to the imaging characteristics,44 case of COP are divided into typical COP group(24 patients)and focal COP group(20 patients).(1)Clinical features:The duration of onset is 2to 12 weeks,and the main clinical manifestations were cough(88.64%),sputumproduction(65.91%),chest pain(34.09%),dyspnea(27.27%),hemoptysis(13.64%),chest tightness(9.09%).Some of them also had systemic symptoms like fever(50%),fatigue(9.09%),chills(9.09%)and so on.31.81% of patients can heard and moist rale,of which typical COP group showed the more cases of moist rale than the COP group.(2)63.64% of OP patients with normal white blood cell count,72.73% of COP patients with normal neutrophilic granulocyte percent,22.73% of COP patients with normal C-reactive protein level,20.45%of COP patients with normal erythrocyte sedimentation rate.Typical COP group:the WBC count was 9.15 ± 3.85 × 10~9 / L,neutrophil percentage was 0.72 ±0.11%,CRP was 29.41 ± 89.58 g / L,ESR was 51.83 ± 31.31 mm.Focal COP group: the WBC count was 7.46 ± 4.49 × 10~9 / L,neutrophil percentage was0.62 ± 0.10%,CRP was 12.26 ± 34.26 g / L,ESR was 35.45 ± 24.49 mm.(3)Pulmonary function tests:Lung function tests may occasionally be normal.75%had varying degrees of diffuse dysfunction(mild 25%,mild to moderate 10.71%,moderate 32.14%,severe 7.14%);28.57% showed mixed ventilatory dysfunction,25% for obstructive ventilatory dysfunction,25% for restrictive ventilatory dysfunction.The diffuse function of pneumonia type COP group was worse than that of focal type.(4)56.82% of COP patients were diagnosed by TBLB,52.27% choosed the transthoracic lung biopsy,4.54% through the surgical biopsy and 4.54% use the video-assisted thoracoscopy obtain lung tissue.Typical COP group:79.2% of patients received TBLB for lung tissue,used B-ultrasound guided percutaneous lung biopsy only 15.4%.Focal COP group: 75% of patients with B-ultrasound guided percutaneous lung biopsy,30% used TBLB for lung tissue.(5)Corticosteroid treatment is effective,about16.13% experience relapses,no difference between the two groups.Conclusions: 1.The manifestations are nonspecific.The most commonimaging is patchy alveolar opacities(typical COP)and solitary opacity(focal COP).2.The patients which the imaging show a typical patchy alveolar opacity are more prone to sputum production,dyspnea,fatigue and other symptoms,and lung examination when the wet rales are also more common.3.The prognosis of corticosteroid treatment is effective,some patients had a relapse. |
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