目的 探讨隐源性机化性肺炎(COP)的临床病理特征和影像学表现.方法 分析5例隐源性机化性肺炎病例的临床特点、影像学表现、肺活检的病理特征,并复习相关文献.结果 COP常见的临床表现为咳嗽、进行性呼吸困难和吸气末肺部爆裂音.肺活检病理检查显示肺泡管、肺泡腔内见肉芽组织栓.胸部CT表现为含支气管充气征的实变阴影,伴或不伴磨玻璃影.患者对糖皮质激素治疗有显著疗效.结论 临床表现结合影像学特点可提示COP临床诊断,肺活检是诊断COP有效的检查方法.%Objective To study the clinical and pathological features and imaging manifestations of cryptogenic organizing pneumonia ( COP) and to promote the awareness of this disease. Method The clinical features, imaging manifestations, electronic broncho-scopic findings and pathological features of 5 patients with COP comfirmed by lung biopsy were analysed, and the literatures were reviewed. Results The most common clinical manifestations of COP were cough, progressive dyspnea and end-inspiratory sparse crackles. Pathologic examination of lung biopsy specimens showed buds of granulation tissue within alveolar ducts and alveoli consisting of fibro-blasts. Chest CT scan findings consist of consolidation with an air bronchosram, mainly subpleuial and/or peribronchovascular, with or without ground-glass opacities. Remarkable response to corticostetoids was found in our patients. Conclusion Clinical diagnosis of COP can be surgested according to the clinical characteristies and typical imaging features. Although transbronchial lung biopsy and percutaneous lung biopsy are useful techniques, video-assisted tholacoscopic lung biopsy and open lung biopsy are more valuable for diagnosing.
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