Document Detail


Idiopathic bronchiolitis obliterans organizing pneumonia/cryptogenic organizing pneumonia with unfavorable outcome: pathologic predictors.
MedLine Citation:
PMID:  9310948     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Idiopathic bronchiolitis obliterans organizing pneumonia (BOOP) and cryptogenic organizing pneumonia (COP) are synonyms for an inflammatory interstitial process characterized by young fibromyxoid connective tissue within airways and air spaces. This clinicopathologic condition is associated with an excellent response to steroidal therapy in more than 80% of patients. In this study, we examined matched groups of 10 patients with steroid-responsive idiopathic BOOP/COP and 9 patients with idiopathic BOOP/COP who fared poorly despite therapy. No significant differences in demographics, symptoms, or radiographic appearances were noted between the two cohorts. Histologic examination revealed that the cases with progressive, idiopathic BOOP/COP were accompanied by scarring and remodeling of the background lung parenchyma in 89% of cases, in contrast to 10% of those with a good prognosis. This finding provided a potential morphologic marker of outcome for therapy in idiopathic BOOP/COP. Steroid-nonresponsive cases of BOOP/COP may have a propensity to cause irreversible injury to the lung, a feature not seen in cases with a good outcome. Another explanation may be that such cases represent a BOOP/COP-like reaction pattern in patients with an associated fibrosing interstitial pneumonia, especially usual interstitial pneumonia. The differential diagnosis of BOOP/COP with organizing diffuse alveolar damage, eosinophilic pneumonia, and other chronic interstitial pneumonias is discussed.
Authors:
S A Yousem; R H Lohr; T V Colby
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc     Volume:  10     ISSN:  0893-3952     ISO Abbreviation:  Mod. Pathol.     Publication Date:  1997 Sep 
Date Detail:
Created Date:  1997-11-06     Completed Date:  1997-11-06     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  8806605     Medline TA:  Mod Pathol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  864-71     Citation Subset:  IM    
Affiliation:
Department of Pathology, University of Pittsburgh School of Medicine, Pennsylvania, USA.
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MeSH Terms
Descriptor/Qualifier:
Adrenal Cortex Hormones / therapeutic use
Adult
Aged
Aged, 80 and over
Biopsy
Cryptogenic Organizing Pneumonia / drug therapy,  pathology*
Diagnosis, Differential
Female
Humans
Lung / pathology*
Male
Middle Aged
Treatment Outcome
Chemical
Reg. No./Substance:
0/Adrenal Cortex Hormones

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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