Miladinović-Djukanović Natasa, Djoković Jelena, Torbica Nikola, Popević Martin
Srp Arh Celok Lek. 2009 Nov-Dec;137(11-12):681-3. doi: 10.2298/sarh0912681m.
Cryptogenic organising pneumonia is a particular form of inflammatory and fibroproliferative lung disease. The disease onset is subacute with cough, dyspnoea, fever, weight loss, and elevation of biological inflammatory markers. Chest imaging usually shows multifocal alveolar opacities predominating in the subpleural regions. Lung biopsy reveals budding connective tissue filling the distal airspaces.
A 57-year-old electrician complaining of cough, dyspnoea, and fatigue was diagnosed with pneumonia and treated with antibiotics and antihistaminics. After clinical and radiographic progression of the disease, open lung biopsy was performed, some 15 months after the disease onset. The diagnosis of cryptogenic organising pneumonia was made. The patient was treated with oral and inhalatory corticosteroids and finally with cytostatics, which led to a partial improvement of his condition. However, work capacity was lost and the quality of life seriously deteriorated.
The diagnosis is established by combining clinical, radiological and histological criteria. Similarities with other disease processes can lead to a delayed or erroneous diagnosis. Most patients respond well to corticosteroid therapy (prednisone or methyl-prednisolone). Relapses are frequent but can generally be controlled.
隐源性机化性肺炎是一种特殊形式的炎症性和纤维增生性肺病。疾病起病亚急性，表现为咳嗽、呼吸困难、发热、体重减轻以及生物学炎症标志物升高。胸部影像学通常显示以胸膜下区域为主的多灶性肺泡实变。肺活检显示有芽生的结缔组织填充远端气腔。
一名57岁的电工，主诉咳嗽、呼吸困难和疲劳，被诊断为肺炎，并接受了抗生素和抗组胺药治疗。在疾病临床和影像学进展后，于疾病发作约15个月后进行了开胸肺活检。诊断为隐源性机化性肺炎。患者接受了口服和吸入性皮质类固醇治疗，最后使用了细胞抑制剂，病情得到部分改善。然而，患者丧失了工作能力，生活质量严重下降。
通过结合临床、放射学和组织学标准来确立诊断。与其他疾病过程的相似性可能导致诊断延迟或错误。大多数患者对皮质类固醇治疗（泼尼松或甲泼尼龙）反应良好。复发频繁，但一般可得到控制。
