Lazor Romain
Service de pneumologie, BHHC, hôpital universitaire de Berne, 3010 Berne, Suisse.
Rev Prat. 2007 Dec 31;57(20):2243-8.
Organising pneumonia is an inflammatory and fibroproliferative reaction of the lung, which gives rise to a clinico-pathological syndrome. It may occur without any detectable cause (cryptogenic organising pneumonia) or may be associated with various processes such as infections, drug toxicities, connective tissue disorders, etc. (secondary organising pneumonia). The clinical picture is usually subacute and includes fever, fatigue, weight loss, cough, dyspnea, crackles, and elevated inflammatory markers. At imaging, the most typical pattern consists of multiple subpleural consolidations. Bronchoalveolar lavage reveals a mixed alveolitis with lymphocytes and polymorphonuclear cells. Lung biopsy shows buds of loose connective tissue filling the lung alveoli. The diagnosis is made by combination of clinical, imaging and histopathological criteria. Most patients respond very well to corticosteroid therapy. Relapses are common but can usually be controlled with moderate doses of prednisone, and do not worsen the prognosis.
机化性肺炎是肺部的一种炎症和纤维增生性反应，可引发一种临床病理综合征。它可能在没有任何可检测到的病因的情况下发生（隐源性机化性肺炎），也可能与各种过程相关，如感染、药物毒性、结缔组织疾病等（继发性机化性肺炎）。临床表现通常为亚急性，包括发热、疲劳、体重减轻、咳嗽、呼吸困难、啰音和炎症标志物升高。在影像学上，最典型的表现是多个胸膜下实变。支气管肺泡灌洗显示混合性肺泡炎，伴有淋巴细胞和多形核细胞。肺活检显示疏松结缔组织芽填充肺泡。诊断通过临床、影像学和组织病理学标准相结合做出。大多数患者对皮质类固醇治疗反应良好。复发很常见，但通常可以用中等剂量的泼尼松控制，且不会恶化预后。
