pulmonary disorders
Cryptogenic Organizing Pneumonia
Diagnosis of Cryptogenic Organizing Pneumonia
High-resolution CT (HRCT) Sometimes lung biopsy Diagnosis of cryptogenic organizing pneumonia requires imaging tests and, if the diagnosis is not otherwise clear, lung biopsy. shows bilateral, diffuse, peripherally distributed alveolar opacities with normal lung volumes; a peripheral distribution similar to Chronic Eosinophilic Pneumonia may occur. Rarely, alveolar opacities are unilateral. Recurrent and migratory pulmonary opacities are common. Rarely, irregular linear or nodular interstitial opacities or honeycombing are visible at presentation. HRCTof the lung shows patchy airspace consolidation (present in 90% of patients), ground-glass opacities, small nodular opacities, and bronchial wall thickening and dilation. The patchy opacities are more common in the periphery of the lung, often in the lower lung zone. HRCT may show much more extensive disease than is expected from review of the chest x-ray. Overview of Tests of Pulmonary Function None Routine laboratory testresults are nonspecific. Leukocytosis without an increase in eosinophils occurs in about one half of patients. The initial erythrocyte sedimentation rate (ESR) often is elevated. (surgical or bronchoscopic) shows excessive proliferation of granulation tissue within small airways and alveolar ducts, with chronic inflammation in the surrounding alveoli. Foci of organizing pneumonia are nonspecific and can occur secondary to other pathologic processes, including infections, vasculitis, Overview of Lymphoma , and other interstitial lung diseases such as 