Kunal Shekhar, Pilaniya Vikas, Jain Sudhir, Shah Ashok
Department of Pulmonary Medicine, Vallabhbhai Patel Chest Institute, University of Delhi, Delhi, India.
Department of Pathology, Oncquest Lab, New Delhi, India.
BMJ Case Rep. 2016 May 6;2016:bcr2016215445. doi: 10.1136/bcr-2016-215445.
Organising pneumonia (OP) is a distinct but uncommon entity with characteristic clinicoradiological features and histological findings. When the aetiology of OP remains unknown, it is termed as cryptogenic OP (COP). COP is seen in the majority of patients with OP and usually observed in non/former smokers. A 54-year-old man, a smoker, presented with breathlessness, cough and mucoid sputum. Imaging demonstrated unilateral 'Crazy-paving' pattern in the left upper lobe and left-sided effusion. In addition, paraseptal emphysema and left lower lobe bullae along with very severe obstructive ventilatory defect and impaired diffusion suggested chronic obstructive pulmonary disease (COPD). Transbronchial biopsy was suggestive of OP. In the absence of a definite aetiology, a diagnosis of COP associated with COPD was established. COP presenting as a unilateral 'Crazy-paving' pattern is yet to be documented. To the best of our knowledge, this is the first detailed description of COP presenting as unilateral 'Crazy-paving' pattern associated with COPD.
机化性肺炎（OP）是一种独特但不常见的疾病，具有特征性的临床放射学特征和组织学表现。当OP的病因不明时，称为隐源性机化性肺炎（COP）。COP见于大多数OP患者，通常在非吸烟者/既往吸烟者中观察到。一名54岁男性吸烟者，出现呼吸困难、咳嗽和黏液痰。影像学显示左上叶单侧“铺路石征”和左侧胸腔积液。此外，间隔旁肺气肿和左下叶肺大疱，以及非常严重的阻塞性通气功能障碍和弥散功能受损提示慢性阻塞性肺疾病（COPD）。经支气管活检提示为OP。在没有明确病因的情况下，确诊为与COPD相关的COP。表现为单侧“铺路石征”的COP尚未见文献报道。据我们所知，这是首次对表现为单侧“铺路石征”且与COPD相关的COP进行详细描述。
