1 Department of Respiratory Medicine, Nanjing Drum Tower Hospital Affiliated to Medical School of Nanjing University, Nanjing 210008, China ; 2 Department of Respiratory Medicine, Jinling Hospital, Medical School of Nanjing University, Nanjing 210002, China ; 3 Department of Pathology, Nanjing Drum Tower Hospital Affiliated to Medical School of Nanjing University, Nanjing 210008, China.
J Thorac Dis. 2014 Sep;6(9):1251-60. doi: 10.3978/j.issn.2072-1439.2014.08.23.
Small biopsy samples are generally considered inconclusive for bronchiolitis obliterans organizing pneumonia (BOOP) diagnosis despite their potential to reveal organizing pneumonia (OP) pathologically, necessitating risky invasive tissue biopsy during surgery for reliable confirmation.
OP by CT-guided lung biopsy was to evaluate the role in the diagnosis of BOOP.
A retrospective review of 134 cases with the OP feature in the CT-guided lung biopsy samples between 2004 and 2011 at a single center was conducted. Diagnostic accuracy of OP by CT-guided lung biopsy and clinical-radiographic data alone were compared.
After exclusion of 11 cases due to pathology with others besides OP and 15 cases for loss to follow-up, 108 were included. Of these, 95 cases and 13 cases were classified as BOOP and non-BOOP group, respectively. Among BOOP group, only 30 were initially diagnosed as BOOP according to the typical clinical and radiographic features. The other 65 cases with atypical features were diagnosed as BOOP mainly based on OP by CT-guided lung biopsy. Among non-BOOP group, one was misdiagnosed as BOOP, and others were not BOOP according to clinical and radiographic findings. Thus, OP by CT-guided lung biopsy produced a diagnostic accuracy of 87.96% (95/108), much higher than 31.25% (30/96) observed using clinical and radiographic data alone. Combined, these techniques produced diagnostic accuracy of 98.96% (95/96).
OP by CT-guided lung biopsy can be effectively used as the pathological evidence for BOOP diagnosis and reducing unnecessary surgery.
尽管小活检样本具有揭示机化性肺炎（OP）病理的潜力，但通常仍被认为对诊断缩窄性细支气管炎伴机化性肺炎（BOOP）不具决定性，因此需要在手术中进行有风险的侵袭性组织活检以获得可靠的确诊。
通过 CT 引导下的肺活检来评估 OP 在 BOOP 诊断中的作用。
回顾性分析了 2004 年至 2011 年期间在一家中心进行的 134 例 CT 引导下肺活检样本中具有 OP 特征的病例。比较了 CT 引导下肺活检和单独临床影像学数据对 OP 的诊断准确性。
排除了 11 例病理除 OP 外还有其他表现的病例和 15 例失访病例后，共纳入 108 例患者。其中，95 例和 13 例分别归类为 BOOP 和非 BOOP 组。在 BOOP 组中，仅有 30 例最初根据典型的临床和影像学特征诊断为 BOOP。其余 65 例不典型特征的病例主要根据 CT 引导下肺活检的 OP 诊断为 BOOP。在非 BOOP 组中，有 1 例误诊为 BOOP，其余病例根据临床和影像学发现均非 BOOP。因此，CT 引导下肺活检的 OP 诊断准确率为 87.96%（95/108），明显高于仅使用临床和影像学数据的 31.25%（30/96）。联合使用这些技术的诊断准确率为 98.96%（95/96）。
CT 引导下肺活检的 OP 可有效用于 BOOP 诊断的病理证据，并减少不必要的手术。
