Volume 7, Number 16;  February 3, 2007

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Session Handout:

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Unique Identifier [PMID]: 16093817

Authors: Schlesinger C. Koss MN.

Institution: Keck School of Medicine of University of Southern California, Los Angeles, CA 90033, USA.

Title: The organizing pneumonias: an update and review. [Review] [97 refs]

Source: Current Opinion in Pulmonary Medicine. 11(5):422-30, 2005 Sep.

Abstract: PURPOSE OF REVIEW: Basic information as well as more recent concepts regarding cryptogenic organizing pneumonia and secondary forms of the disease. RECENT FINDINGS: More recently described and less well recognized illnesses associated with organizing pneumonia, such as organizing pneumonia associated with radiation, are enumerated. In vitro studies from separate laboratories are integrated to create a proposed model of the pathogenesis and repair mechanisms that occur in organizing pneumonias. Using current criteria, we note other interstitial lung processes, in addition to organizing pneumonia, are present in some earlier reports. SUMMARY: Cryptogenic organizing pneumonia has been reported to respond to corticosteroids with clinico-radiographic resolution in 70-80% of cases. Treatment duration is lengthy, and despite this, recurrences and late recurrences are common. Rapidly progressive, steroid resistant and poor prognostic forms of organizing pneumonia have been described and have been reported more frequently with secondary organizing pneumonia. Since other histologic interstitial patterns often coexist with organizing pneumonia, tissue sampling error or an incorrect morphologic diagnosis can be the reason for aggressive clinical behavior. Steroid nonresponsive patients have been treated with secondary non-steroidal agents. Good clinical outcomes have been reported. Inhaled antigens stimulate GM-CSF-mediated airway inflammation in organizing pneumonia. Repair requires the following: granulation tissue, upon which re-epithelialization occurs; a favorable stromal ratio of matrix metalloproteinase to tissue inhibitors of metalloproteinase; concurrent resolution of inflammation; and stromal fibroblast ingestion of collagen produced earlier in repair, reversing the initial fibrosis. [References: 97]

Publication Type: Journal Article. Review.

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Unique Identifier [PMID]: 15564019

Authors: Vourlekis JS.

Institution: Lung and Upper Aerodigestive Cancer Research Group, Division of Cancer Prevention, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA. vourlekj@mail.nih.gov

Title: Acute interstitial pneumonia. [Review] [53 refs]

Source: Clinics in Chest Medicine. 25(4):739-47, vii, 2004 Dec.

Abstract: The idiopathic interstitial pneumonias have unknown etiology and are characterized by diffuse parenchymal lung involvement and the potential to develop pulmonary fibrosis. Most portend a reduction in life expectancy due, in part, to the absence of effective therapies. The symptoms of idiopathic interstitial pneumonia develop insidiously. In contradistinction, acute interstitial pneumonia (AIP, also known as acute interstitial pneumonitis) is unique in that it has a very rapid to fulminant onset, leading to early hospitalization and a high initial case fatality ratio but, potentially, a more favorable long-term prognosis for survivors. Despite its contemporary description nearly 20 years ago, knowledge of this disease has increased little. This review focuses on AIP and its current place among the idiopathic interstitial pneumonias. [References: 53]

Publication Type: Journal Article. Review.

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Unique Identifier [PMID]: 15564018

Authors: Cordier JF.

Institution: Department of Respiratory Medicine and Center for Orphan Lung Diseases, Louis Pradel Hospital, Claude Bernard University, 28 Avenue Doyen Lepine, 69677 Lyon (Bron), France. jean-francois.cordier@chu-lyon.fr

Title: Cryptogenic organizing pneumonia. [Review] [115 refs]

Source: Clinics in Chest Medicine. 25(4):727-38, vi-vii, 2004 Dec.

Abstract: Cryptogenic organizing pneumonia is a rare, distinct disorder that is sufficiently different from the other diseases in the group of idiopathic interstitial pneumonias to be designated as a separate entity. In its most typical presentation, it is characterized by dyspnea and cough, with multiple patchy alveolar opacities on pulmonary imaging. Definite diagnosis is obtained by the finding of buds of granulation tissue in the distal airspaces at lung biopsy. No cause (as infection, drug reaction, or associated disease as connective tissue disease) is found. Corticosteroid treatment is rapidly effective, but relapses are common on reducing or stopping treatment. [References: 115]

Publication Type: Journal Article. Review.

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Unique Identifier [PMID]: 12042959

Authors: Oikonomou A. Hansell DM.

Institution: Department of Radiology, Royal Brompton Hospital, Sydney Street, London SW3 6NP, England.

Title: Organizing pneumonia: the many morphological faces. [Review] [100 refs]

Source: European Radiology. 12(6):1486-96, 2002 Jun.

Abstract: Organizing pneumonia is a non-specific response to various forms of lung injury and is the pathological hallmark of the distinct clinical entity termed cryptogenic organizing pneumonia. The typical imaging features of this syndrome have been widely documented and consist of patchy air-space consolidation, often subpleural, with or without ground-glass opacities. The purpose of this article is to highlight the less familiar imaging patterns of organizing pneumonia which include focal organizing pneumonia, a variety of nodular patterns, a bronchocentric distribution, band-like opacities, a perilobular pattern and a progressive fibrotic form of organizing pneumonia. [References: 100]

Publication Type: Journal Article. Review.

Resident Report / Department of Medicine & Grady Branch Library

Emory University School of Medicine

2006 Edition

Participating Faculty:  Carlos Del Rio MD  / Joyce Doyle MD / Lorenzo Difrancesco MD / Joel Mermis MD / Maunank Shah MD

Contact: Karl Woodworth