Garay J B, Zurdo M R, López O A, Gaviria A Z, Medina L V, Delgado E G, Entrecanales M V, Galiana J R
Servicio de Medicina Interna, Hospital de Móstoles, Madrid.
Rev Clin Esp. 1996 Feb;196(2):103-6.
Bronchiolitis obliterans with organizing pneumonia (BOOP) is recently described clinicopathological entity, with only a few series of patients reported. Terminology is unclear, which together with its rarity lead to a poor understanding of the entity.
To review the clinical, radiological, and laboratory features and the response to therapy in cases of BOOP in our environment.
A total of 463 lung biopsies were obtained at Móstoles Hospital, Madrid, from 1992 to 1994. In six cases the anatomo-pathological diagnosis was BOOP. Clinical histories of these patients were reviewed.
Six patients were diagnosed with BOOP. From these six patients, four (66%) were female, with a mean age of 59 years (45-74 years). Three patients (50%) were smokers. BOOP was idiopathic in four cases (66%) and secondary to rheumatoid arthritis in one (17%) and Legionella pneumonia in another patient (17%). Patients presented with cough and dyspnea (100%), chest pain and constitutional syndrome (66%) and fever (34%) of one to eight weeks evolution. Laboratory data included: increased ESR (100%), abnormal levels of liver enzymes (83%), hypoxemia (83%) and abnormal spirometry (50%). Radiological studies demonstrated alveolar infiltrates in 83%, predominantly in lower lobes, which were of a migratory nature in 33%. CT, performed in five patients, demonstrated alveolar infiltrates in all patients, which were bilateral and peripheric in two. Transbronchial biopsy was diagnostic in five cases, and in one patient thoracotomy had to be performed. One patient died (17%); the remaining patients (83%) improved with steroids, although 34% relapsed. Mean follow-up time was eleven months (5-24 months).
BOOP observed in our environment is a rare entity, usually of an idiopathic nature, which presents with characteristic clinical course and laboratory findings. Transbronchial biopsy is diagnostic in many patients. The clinical course is good with steroids in most patients, although relapses are common.
闭塞性细支气管炎伴机化性肺炎（BOOP）是一种最近才被描述的临床病理实体，仅有少数系列病例报道。其术语尚不明确，加之其罕见性，导致对该实体的认识不足。
回顾我院环境中BOOP病例的临床、放射学和实验室特征以及对治疗的反应。
1992年至1994年期间，在马德里莫斯托莱斯医院共获取了463份肺活检标本。其中6例经解剖病理学诊断为BOOP。对这些患者的临床病史进行了回顾。
6例患者被诊断为BOOP。在这6例患者中，4例（66%）为女性，平均年龄59岁（45 - 74岁）。3例患者（50%）为吸烟者。BOOP在4例（66%）中为特发性，1例（17%）继发于类风湿性关节炎，另1例（17%）继发于军团菌肺炎。患者表现为咳嗽和呼吸困难（100%）、胸痛和全身症状（66%）以及发热（34%），病程为1至8周。实验室检查数据包括：血沉升高（100%）、肝酶水平异常（83%）、低氧血症（83%）和肺功能异常（50%）。放射学研究显示83%的患者有肺泡浸润，主要在肺下叶，其中33%为游走性。5例患者进行了CT检查，所有患者均显示肺泡浸润，其中2例为双侧周边性。经支气管活检在5例中具有诊断价值，1例患者需进行开胸手术。1例患者死亡（17%）；其余患者（83%）使用类固醇后病情改善，尽管34%复发。平均随访时间为11个月（5 - 24个月）。
在我院环境中观察到的BOOP是一种罕见实体，通常为特发性，具有特征性的临床病程和实验室检查结果。经支气管活检对许多患者具有诊断价值。大多数患者使用类固醇后临床病程良好，尽管复发常见。
