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《Chinese Journal of Difficult and Complicated Cases》 2017-12
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Clinical analysis of 19 cases of focal organizing pneumonia

HE Yanxia;WU Wenjie;XIONG Xin;LI Xiuye;XUE Bing;GE Hongxia;Department of Respiratory,the Chuiyangliu Hospital;  
Objective To analyze the clinical and imaging features of focal organizing pneumonia( FOP) and its possible etiology. Methods From August 2010 to February 2016,retrospective analyzed clinical and imaging data of 19 cases of FOP patients,who were with pathological diagnosis in department of respiratory medicine from Beijing Chuiyangliu Hospital and department of emergency from No. 3 Hospital of Peking University,on the basis of the lesion whether more than 3 cm or not,and whether any secondary etiology for idiopathic and secondary FOP,analyzed the different size of lesions and clinical features of idiopathic and secondary FOP. Results FOP lack of specific clinical symptoms,compared with 3 cm FOP and more than or equal to 3 cm lesions,there was no significant difference between them in clinical symptoms. Peripheral lung field distribution,polygon,contact with pleural broadly,uneven density,the surrounding tissue blurred border are helpful to diagnosis of more than or equal to 3 cm FOP,but 3 cm FOP has a clear border,vacuole sign,spicule sign and other characteristics,the initial misdiagnosis rate is high. In 19 cases of FOP,secondary causes were found in 5 cases: 3 cases associated with infection; 1 cases of biopsy showed acid fast staining positive; 1 cases due to the dynamic increase of the lesions,surgical resection of adenocarcinoma cells. Conclusion The clinical symptoms contribute less to FOP diagnosis; according to the chest CT,large lesions FOP has certain characteristics,but the 3 cm FOP and lung cancer is difficult to identify; the diagnosis of FOP mainly depends on the pathological,but find secondary causes is important after pathological diagnosis,and should closely monitor the chest CT changes,to prevent misdiagnosis or missed diagnosis.
【CateGory Index】: R563.1
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