Organizing pneumonia
| Bronchiolitis obliterans organizing pneumonia. | |
|---|---|
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| Micrograph showing a Masson body (off center left/bottom of the image – pale circular and paucicellular), as may be seen in bronchiolitis obliterans organizing pneumonia. The Masson body plugs the airway. The artery associated with the obliterated airway is also seen (far left of the image). H&E stain. | |
| Classification and external resources | |
| Specialty | pulmonology |
| ICD-10 | J84.0 |
| ICD-9-CM | 516.8 |
| DiseasesDB | 31684 |
| eMedicine | radio/117 |
| MeSH | D018549 |
Bronchiolitis obliterans organizing pneumonia (BOOP), also known as cryptogenic organizing pneumonia, is a form of non-infectious pneumonia; more specifically, BOOP is an inflammation of the bronchioles (bronchiolitis) and surrounding tissue in the lungs. It is often a complication of an existing chronic inflammatory disease such as rheumatoid arthritis, dermatomyositis, or it can be a side effect of certain medications such as amiodarone. BOOP was first described by Gary Epler in 1985.
Some authors have recommended the use of an alternate name, cryptogenic organizing pneumonia (COP), to reduce confusion with bronchiolitis obliterans, a distinct and unrelated disease.
The clinical features and radiological imaging resemble infectious pneumonia. However, diagnosis is suspected after there is no response to multiple antibiotics, and blood and sputum cultures are negative for organisms.
"Organizing" refers to unresolved pneumonia (in which the alveolar exudate persists and eventually undergoes fibrosis) in which fibrous tissue forms in the alveoli. The phase of resolution and/or remodeling following bacterial infections is commonly referred to as organizing pneumonia, both clinically and pathologically.
The classic presentation of COP is the development of nonspecific systemic (e.g., fevers, chills, night sweats, fatigue, weight loss) and respiratory (e.g. difficulty breathing, cough) symptoms in association with filling of the lung alveoli that is visible on chest x-ray. This presentation is usually so suggestive of an infection that the majority of patients with COP have been treated with at least one failed course of antibiotics by the time the true diagnosis is made.
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