Crestani Bruno, Taillé Camille, Borie Raphaël, Debray Marie-Pierre, Danel Claire, Dombret Marie-Christine, Aubier Michel
Service de pneumologie A et radiologie, Laboratoire d'Anatomie Pathologique, Hôpital Bichat, F-75877 Paris Cedex 18, France.
Presse Med. 2010 Jan;39(1):126-33. doi: 10.1016/j.lpm.2009.10.007. Epub 2009 Nov 28.
Organizing pneumonia is first of all a pathologic entity observed in different situations of pulmonary repair after aggression. It is characterized by the presence in the distal airways (alveoli, alveolar ducts, and respiratory bronchioli) of fibroblastic buds in a loose extracellular matrix. The same terminology also describes a clinical entity characterized by the appearance of patches of multiple alveolar opacities, especially suggestive when they are migratory. This entity is characterized by strong sensitivity to corticosteroids and the high frequency of disease relapses, which generally occur when the corticosteroid dose is reduced or in the weeks after treatment stops. Diagnostic certainty requires histologic proof, which is rarely obtained when the radiographic and clinical picture is typical. When it occurs without an identified cause, this entity is now known as cryptogenic organizing pneumonia (it was previously called bronchiolitis obliterans with organizing pneumonia, or BOOP). The same entity can be observed in other defined contexts (connective tissue disease, for example), or with identified causes (e.g., radiation therapy for breast cancer, drugs, or infections).
机化性肺炎首先是在肺部受到侵袭后的不同修复情况下观察到的一种病理实体。其特征是在远端气道（肺泡、肺泡管和呼吸性细支气管）中存在处于疏松细胞外基质中的成纤维细胞芽。相同的术语也描述了一种临床实体，其特征是出现多个肺泡性混浊斑，尤其是当它们呈游走性时具有提示意义。该实体对皮质类固醇具有高度敏感性，且疾病复发频率高，复发通常发生在皮质类固醇剂量减少时或治疗停止后的几周内。诊断的确切性需要组织学证据，而当影像学和临床症状典型时很少能获得该证据。当它无明确病因发生时，这种实体现在被称为隐源性机化性肺炎（它以前被称为闭塞性细支气管炎伴机化性肺炎，或BOOP）。在其他特定情况下（例如结缔组织病）或有明确病因（如乳腺癌放疗、药物或感染）时也可观察到相同的实体。
