隐源性机化性肺炎2例报告并文献复习

目的探讨并提高对隐源性机化性肺炎（cryptogenic organizing pneumonia，COP）的认识和诊断治疗能力。方法对2例病理诊断明确的COP病例进行总结并复习文献，探讨COP的临床、病理、影像学特点。结果两例COP均为老年患者，亚急性起病，以发热伴呼吸困难为主要临床症状，均被误诊为CAP，影像学示：肺部呈多叶病变，病变呈游走性，形态多样，有实变影，磨玻璃影及索条影，临床症状与肺部体征及影像学严重程度不符，反复痰病原学检查无阳性发现，使用抗生素治疗无效，均行肺穿刺活检而明确诊断。糖皮质激素治疗有效，随访示预后好。结论临床表现及影像学特征对COP的诊断有一定的提示作用，但确诊需依靠病理检查。经皮肺活检或经支气管镜肺活检对诊断COP有较高的价值。

Two cases reports of cryptogenic organizing pneumonia and review

Objective To analyze and improve the ability of diagnosis and treatment of cryptogenic organizing pneumonia(COP).Methods To analyze the characteristics of pathologically proved two cases of COP including manifestation of clinic,CT scan and pulmonary histopathological appearance and review the literatures.Results Two patients were diagnosed as COP by percutaneous lung biopsy.Fever,dyspnea,cough were the most common symptoms.Chest computed tomography scan showed ground glass opacities,patchy areas of alveolar...