Cryptogenic Organizing Pneumonia: Evolution of Morphological Patterns Assessed by HRCT
Francesco Tiralongo,
Monica Palermo,
Giulio Distefano,
Ada Vancheri,
Gianluca Sambataro,
Sebastiano Emanuele Torrisi,
Federica Galioto,
Agata Ferlito,
Giulia Fazio,
Pietro Valerio Foti,
Letizia Antonella Mauro,
Carlo Vancheri,
Stefano Palmucci,
Antonio Basile
Affiliations
Francesco Tiralongo
Radiology Unit 1, Department of Medical Surgical Sciences and Advanced Technologies “GF Ingrassia”—University Hospital “Policlinico-Vittorio Emanuele”, University of Catania, 95123 Catania, Italy
Monica Palermo
Radiology Unit 1, Department of Medical Surgical Sciences and Advanced Technologies “GF Ingrassia”—University Hospital “Policlinico-Vittorio Emanuele”, University of Catania, 95123 Catania, Italy
Giulio Distefano
Radiology Unit 1, Department of Medical Surgical Sciences and Advanced Technologies “GF Ingrassia”—University Hospital “Policlinico-Vittorio Emanuele”, University of Catania, 95123 Catania, Italy
Ada Vancheri
Regional Referral Centre for Rare Lung Diseases, A. O. U. “Policlinico-Vittorio Emanuele” Dept. of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy
Gianluca Sambataro
Regional Referral Centre for Rare Lung Diseases, A. O. U. “Policlinico-Vittorio Emanuele” Dept. of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy
Sebastiano Emanuele Torrisi
Regional Referral Centre for Rare Lung Diseases, A. O. U. “Policlinico-Vittorio Emanuele” Dept. of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy
Federica Galioto
Radiology Unit 1, Department of Medical Surgical Sciences and Advanced Technologies “GF Ingrassia”—University Hospital “Policlinico-Vittorio Emanuele”, University of Catania, 95123 Catania, Italy
Agata Ferlito
Radiology Unit 1, Department of Medical Surgical Sciences and Advanced Technologies “GF Ingrassia”—University Hospital “Policlinico-Vittorio Emanuele”, University of Catania, 95123 Catania, Italy
Giulia Fazio
Radiology Unit 1, Department of Medical Surgical Sciences and Advanced Technologies “GF Ingrassia”—University Hospital “Policlinico-Vittorio Emanuele”, University of Catania, 95123 Catania, Italy
Pietro Valerio Foti
Radiology Unit 1, Department of Medical Surgical Sciences and Advanced Technologies “GF Ingrassia”—University Hospital “Policlinico-Vittorio Emanuele”, University of Catania, 95123 Catania, Italy
Letizia Antonella Mauro
Radiology Unit 1, Department of Medical Surgical Sciences and Advanced Technologies “GF Ingrassia”—University Hospital “Policlinico-Vittorio Emanuele”, University of Catania, 95123 Catania, Italy
Carlo Vancheri
Regional Referral Centre for Rare Lung Diseases, A. O. U. “Policlinico-Vittorio Emanuele” Dept. of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy
Stefano Palmucci
Radiology Unit 1, Department of Medical Surgical Sciences and Advanced Technologies “GF Ingrassia”—University Hospital “Policlinico-Vittorio Emanuele”, University of Catania, 95123 Catania, Italy
Antonio Basile
Radiology Unit 1, Department of Medical Surgical Sciences and Advanced Technologies “GF Ingrassia”—University Hospital “Policlinico-Vittorio Emanuele”, University of Catania, 95123 Catania, Italy
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.