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Cryptogenic Organizing Pneumonia: Evolution of Morphological Patterns Assessed by HRCT

To evaluate the radiological findings in patients with cryptogenic organizing pneumonia (COP) before steroid treatment and their behavior after therapy, we retrospectively evaluated a total of 22 patients with a diagnosis of COP made by bronchoalveolar lavage (BAL), biopsy or clinical/radiological f...

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Autores principales: Tiralongo, Francesco, Palermo, Monica, Distefano, Giulio, Vancheri, Ada, Sambataro, Gianluca, Torrisi, Sebastiano Emanuele, Galioto, Federica, Ferlito, Agata, Fazio, Giulia, Foti, Pietro Valerio, Mauro, Letizia Antonella, Vancheri, Carlo, Palmucci, Stefano, Basile, Antonio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7277545/
https://www.ncbi.nlm.nih.gov/pubmed/32365469
http://dx.doi.org/10.3390/diagnostics10050262
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author Tiralongo, Francesco
Palermo, Monica
Distefano, Giulio
Vancheri, Ada
Sambataro, Gianluca
Torrisi, Sebastiano Emanuele
Galioto, Federica
Ferlito, Agata
Fazio, Giulia
Foti, Pietro Valerio
Mauro, Letizia Antonella
Vancheri, Carlo
Palmucci, Stefano
Basile, Antonio
author_facet Tiralongo, Francesco
Palermo, Monica
Distefano, Giulio
Vancheri, Ada
Sambataro, Gianluca
Torrisi, Sebastiano Emanuele
Galioto, Federica
Ferlito, Agata
Fazio, Giulia
Foti, Pietro Valerio
Mauro, Letizia Antonella
Vancheri, Carlo
Palmucci, Stefano
Basile, Antonio
author_sort Tiralongo, Francesco
collection PubMed
description To evaluate the radiological findings in patients with cryptogenic organizing pneumonia (COP) before steroid treatment and their behavior after therapy, we retrospectively evaluated a total of 22 patients with a diagnosis of COP made by bronchoalveolar lavage (BAL), biopsy or clinical/radiological features, and the patients were followed between 2014 and 2018 at the hospital; the demographic data, symptoms, radiologic findings, diagnostic methods and treatment plans of patients were collected from patients’ hospital records. At least two CT scans of 22 patients (16 female and six men) were evaluated, the first one before starting steroid therapy and the others after therapy. At baseline CT scans, the most common radiological finding was the presence of consolidations (18/22 patients, 81.8%); ground-glass opacities were also very common (15/25, 68.1%). The other findings were as follows: nodules and masses (5/22, 22.7%), atoll sign (4/22, 18.1%), perilobular pattern (3/22, 13.6%) and parenchymal bands (3/22, 13.6%). Two patients had a significant relapse after reducing/interrupting therapy, while three had a complete resolution and are not currently under therapy (maintenance of clinical remission with no oral corticosteroid (OCS)). In High-resolution computed tomography (HRCT) scans after therapy, consolidations were still observable in seven patients (five in new areas of the lung-migratory infiltrates), while most of them disappeared, leaving a residual area of ground glass opacity in two patients. One patient had a residual of the perilobular pattern, with the disappearing of the other findings (consolidations and ground-glass opacities). Two patients developed a fibrosing pattern despite the therapy (9.5%). Cryptogenic organizing pneumonia tends to respond to oral corticosteroid treatment, but some patients may have a null or partial response. We highlight the behavior of this disease after proper therapy.
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spelling pubmed-72775452020-06-12 Cryptogenic Organizing Pneumonia: Evolution of Morphological Patterns Assessed by HRCT Tiralongo, Francesco Palermo, Monica Distefano, Giulio Vancheri, Ada Sambataro, Gianluca Torrisi, Sebastiano Emanuele Galioto, Federica Ferlito, Agata Fazio, Giulia Foti, Pietro Valerio Mauro, Letizia Antonella Vancheri, Carlo Palmucci, Stefano Basile, Antonio Diagnostics (Basel) Article To evaluate the radiological findings in patients with cryptogenic organizing pneumonia (COP) before steroid treatment and their behavior after therapy, we retrospectively evaluated a total of 22 patients with a diagnosis of COP made by bronchoalveolar lavage (BAL), biopsy or clinical/radiological features, and the patients were followed between 2014 and 2018 at the hospital; the demographic data, symptoms, radiologic findings, diagnostic methods and treatment plans of patients were collected from patients’ hospital records. At least two CT scans of 22 patients (16 female and six men) were evaluated, the first one before starting steroid therapy and the others after therapy. At baseline CT scans, the most common radiological finding was the presence of consolidations (18/22 patients, 81.8%); ground-glass opacities were also very common (15/25, 68.1%). The other findings were as follows: nodules and masses (5/22, 22.7%), atoll sign (4/22, 18.1%), perilobular pattern (3/22, 13.6%) and parenchymal bands (3/22, 13.6%). Two patients had a significant relapse after reducing/interrupting therapy, while three had a complete resolution and are not currently under therapy (maintenance of clinical remission with no oral corticosteroid (OCS)). In High-resolution computed tomography (HRCT) scans after therapy, consolidations were still observable in seven patients (five in new areas of the lung-migratory infiltrates), while most of them disappeared, leaving a residual area of ground glass opacity in two patients. One patient had a residual of the perilobular pattern, with the disappearing of the other findings (consolidations and ground-glass opacities). Two patients developed a fibrosing pattern despite the therapy (9.5%). Cryptogenic organizing pneumonia tends to respond to oral corticosteroid treatment, but some patients may have a null or partial response. We highlight the behavior of this disease after proper therapy. MDPI 2020-04-29 /pmc/articles/PMC7277545/ /pubmed/32365469 http://dx.doi.org/10.3390/diagnostics10050262 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Tiralongo, Francesco
Palermo, Monica
Distefano, Giulio
Vancheri, Ada
Sambataro, Gianluca
Torrisi, Sebastiano Emanuele
Galioto, Federica
Ferlito, Agata
Fazio, Giulia
Foti, Pietro Valerio
Mauro, Letizia Antonella
Vancheri, Carlo
Palmucci, Stefano
Basile, Antonio
Cryptogenic Organizing Pneumonia: Evolution of Morphological Patterns Assessed by HRCT
title Cryptogenic Organizing Pneumonia: Evolution of Morphological Patterns Assessed by HRCT
title_full Cryptogenic Organizing Pneumonia: Evolution of Morphological Patterns Assessed by HRCT
title_fullStr Cryptogenic Organizing Pneumonia: Evolution of Morphological Patterns Assessed by HRCT
title_full_unstemmed Cryptogenic Organizing Pneumonia: Evolution of Morphological Patterns Assessed by HRCT
title_short Cryptogenic Organizing Pneumonia: Evolution of Morphological Patterns Assessed by HRCT
title_sort cryptogenic organizing pneumonia: evolution of morphological patterns assessed by hrct
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7277545/
https://www.ncbi.nlm.nih.gov/pubmed/32365469
http://dx.doi.org/10.3390/diagnostics10050262
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