Organizing pneumonia: manifestation peculiarities, causes, and outcomes

Abstract

Introduction: Organizing pneumonia (OP) is a rare disorder which may be associated with various clinical contexts and radiological patterns. Objectives: To evaluate prospective peculiarities of the manifestation of OP, which may improve the of characterization of the disorder. Material and Methods: Forty consecutive patients with a biopsy proven OP were investigated. Clinical symptoms, radiographic signs, and laboratory indices (complete blood cell counts, CRP level, BAL fluid examination) were examined. All patients underwent investigation for possible underlying pathology and associations. Results: 62.5% of patients had mild-to-moderate respiratory symptoms, 17.5% had severe respiratory symptoms, while the remaining 20% were asymptomatic (an incidental finding on chest radiographs). Severity of the disease correlated with CRP level, but did not correlate with blood leukocytes. Multiple bilateral infiltrates were detected in 35%, a single infiltrate in 40%, a solitary mass in 12.5%, multiple small nodules in 10%, and diffuse ground glass appearance in 2.5% of all cases. Air bronchograms were present in 45%, cavitations in 12.5%, and pleurisy in 7.5% of all lesions. OP occurred in association with infections (53%), neoplastic diseases (23%), both (7%), and other disorders (7%). A cryptogenic origin of OP was in 10% of all cases. Conclusion: OP mostly manifested with mild-to-moderate respiratory symptoms and single or multiple lung infiltrates. OP varied in clinical and radiological forms. OP associated mostly with infection and/or neoplasm in our patients. Other reasons and cryptogenic origins of the disorder were rare.