Objective: To assess the radiographic, computed tomography (CT) and pathologic findings and response to therapy of cryptogenic organizing pneumonia in immunocompromised patients.
Patients and methods: The study group consisted of 12 consecutive immunocompromised patients (seven men and five women), examined between July 1988 and July 1993, who had pathologically proven cryptogenic organizing pneumonia and for whom chest radiographs and CT scans had been obtained within 9 days of diagnosis. The 12 patients were treated with corticosteroids and underwent follow-up radiography.
Results: The findings of chest radiography included consolidation (in 10 patients), reticulation (in 3) and small nodules (in 2). None of the radiographic abnormalities were localized to particular zones of the lung. The CT findings included ground-glass attenuation (in nine patients), consolidation (in six), small nodules (in five) and reticulation (in two). In 8 of the 12 patients (67%) these abnormalities were most marked in the subpleural and peribronchovascular regions. The follow-up radiographs showed improvement in 11 (92%) of the patients.
Conclusions: The most common radiographic abnormality associated with cryptogenic organizing pneumonia in these immunocompromised patients was consolidation, and the most common CT finding was ground-glass attenuation with or without associated consolidation or nodules. Most of the patients responded to corticosteroid therapy, irrespective of the initial radiologic pattern.