Klinik, Labaratuvar, Tedaviye Yanıt Ve Radyografi İle Organize Pnömoni Tanısı

Amaç: Organize pnömoni (OP)non-spesifik semptomlar, radyografik bulgular ve pulmoner fonksiyon testlerinde anormalliklerle ilişkili kinik bir durumdur.Radyografik bulgular tekrarlayan, göç eden bilateral yamalı infiltrasyonlar şeklindedir.OP tanısı; transbronşiyal biyopsi ve bronkoalveolar lavaj (BAL) yapılmadığında kliniğe ve bilgisayarlı tomografi (BT) bulgularına bağlıdır. Bizde çalışmamızda biyopsi olmadan klinik, laboratuar, tedaviye yanıt ve radyolojik bulgularla OP tanısı konulanabilir mi sorusunu açıklamaya çalıştık. Materyal ve Metod:Kliniğimizde dosyalar taranarak organize pnömoni tanısı konulup tedavi başlanan 24 hasta alındı.Yaşları, geliş şikâyetleri, tanıdan önce ne kadar zamandır şikâyetleri olduğu, radyolojik bulguları, bronkoskopi geçmişleri, solunum fonksiyon testleri (SFT), tedavi sonrası radyolojik bulguları, tedaviye cevap verip vermedikleri kayıt altına alındı. Bulgular:24 hastanın 17' si bayan, 7 tanesi erkekdi. Yaş ortalamaları 53,9±12,32 idi. 18 (%75) ikriptojenik organize pnömoni, 6 (%25)sısekonder organize pnömoni idi. BT bulguları olarak 16 (%66,7) hastada buzlu cam, 14 (%58,3) hastada konsolidasyon saptanmıştır. Sonuç:Klinik ve radyolojik bulgularla organize pnömoni tanısı konulabileceğini ve tedavi başlanabileceğini düşünüyoruz.

Anahtar Kelimeler:

Akciğer, Kriptojenik Organize Pnömoni, Radyolojik Bulgular

Organizing Pneumonia Diagnosis With Radiograpy, Clinical, Laboratory And Response To Treatment

Background: Organizing pneumonia (OP) is a clinical condition associated with abnormal results of pulmonary function tests, radiographic findings, and non-specific symptoms. Radiographic findings are in the form of recurrent, migrating bilateral patchy infiltrations. OP diagnosis: depends on clinical and in computed tomography (CT) findings in the absence of biopsy and bronchoalveoler lavage (BAL). In our study, the question “Can organizing pneumonia diagnosis be established?“ is tried to explain with clinical, laboratory, response to treatment, and radiological findings without biopsy. Method: Patients that diagnosed organizing pneumonia and started treatment are enrolled with scanning files in our clinics. Their age, developed complaints, time of complaints existence before diagnosis, radiological findings, bronchoscopy history, pulmonary function tests (PFT), post-treatment radiological findings, and whether or not they respond to treatment were recorded. Results: 17 patients out of 24 were females, and 7 of them were males. Mean age was 53.9 ± 12.32. 18 (75%) had cryptogenic organizing pneumonia, 6 (25%) had secondary organizing pneumonia. In computed tomography (CT) findings, it was observed ground-glass in 16 (66.7%) patients, and consolidation in 14 (58.3%) patients. Conclusion: The diagnosis of organizing pneumonia can be made with the clinical and radiological findings and treatment can be started.

Keywords:

Lung, Cryptogenic Organizing Pneumonia, Radiological Findings,

PDF

___

1.Drakopanagiotakis F, Paschalaki K, Abu-Hijleh M, Aswad B, Karagianidis N, Kastanakis E, et al. Cryptogenic and secondary organizing pneumonia: clinical presentation, radiographic findings, treatment response, and prognosis. Chest 2011;139(4):893-900.
2.Zhao F, Yan SX, Wang GF, Wang J, Lu PX, Chen B. CT features of focal organizing pneumonia: an analysis of consecutive histopathologically confirmed 45 cases. Eur J Radiol2014;83(1):73-8.
3.Nishino M, Mathai SK, Schoenfeld D, Digumarthy SR, Kradin RL. Clinicopathologic features associated with relapse in cryptogenic organizing pneumonia. Hum Pathol 2014;45(2):342-51.
4.Roberton BJ, Hansell DM. Organizing pneumonia: a kaleidoscope of concepts and morphologies. EurRadiol 2011;21(11):2244-54.
5.Gómez A, Martínez R, Gotway MB. Organizing pneumonia associated with swine-origin influenza A H1N1 2009 viral infection. Am J Roentgenol 2011;196(1):103-4.
6.Jara-Palomares L, Gomez-Izquierdo L, GonzalezVergara D, Rodriguez-Becerra E, Marquez-Martin E, Barrot-Cortés E, et al Utility of high-resolution computed tomography and BAL in cryptogenic organizing pneumonia. RespirMed 2010;104(11):1706-11.
7.Morell F, Reyes L, Doménech G, De Gracia J, Majó J, Ferrer J.Diagnoses and diagnostic procedures in 500 consecutive patients with clinical suspicion of interstitial lung disease. ArchBronconeumol 2008;44(4):185-91.
8.Clinical guidelines and indications for bronchoalveolar lavage (BAL): report of the European Society of pneumology task groupon BAL. EurRespir J 1990;3:937- 76.
9.MartínJuan J, ValenzuelaMateos F, SotoCampos G, SegadoSoriano A, RodríguezPanadero F, CastilloGómez J. Quality and selection of samples of bronchoalveolar l a v a g e (BAL) i n d iff u s e p n e umo p a t h i e s. ArchBronconeumol 1996;32(7):332-40.
10.Castella J, Ancochea J, Llorente L, Puzo C, Sanchis J, Sueiro A, Xaubet A.Bronchoalveolar lavage. ArchBronconeumol 1997;33:515-26.
11.Swens en SJ, Aughenbaugh GL, Mye rs JL.Diffuselungdisease: diagnostic accuracy of CT in patients undergoing surgical biopsy of the lung.Radiology 1997;205(1):229-34.
12.Gudmundsson G, Sveinsson O, Isaksson HJ, Jonsson S, Frodadottir H, Aspelund T.Epidemiology of organising pneumonia in Iceland. Thorax 2006;61(9):805-8.
13.Baque-Juston M, Pellegrin A, Leroy S, Marquette CH, Padovani B.Organizing pneumonia: what is it? A c o n c e p t u a l a p p r o a c h a n d p i c t o ri a l r e v i ew. DiagnIntervImaging 2014;95(9):771-7.
14.Poletti V, Cazzato S, Minicuci N, Zompatori M, Burzi M, Schiattone ML. The diagnostic value of bronchoalveolar lavage and transbronchial lung biopsy in cryptogenic organizing pneumonia.EurRespir J 1996;9(12):2513-6.
15.Alasaly K, Muller N, Ostrow DN, Champion P, FitzGerald JM. Cryptogenic organizing pneumonia. A report of 25 cases and a review of the literature.Medicine (Baltimore) 1995;74(4):201-11.
16.Huo Z, Feng R, Tian X, Zhang H, Huo L, Liu H.Clinicopathological findings of focal organizing pneumonia: a retrospective study of 37 cases. Int J ClinExpPathol 2015;8(1):511-6.