Cryptogenic organizing pneumonia pathophysiology

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Manpreet Kaur, MD [2] Serge Korjian M.D.

Overview

Cryptogenic organizing pneumonia is an idiopathic diffuse interstitial lung disease that affects the distal bronchioles, respiratory bronchioles, alveolar ducts, and alveolar walls. The injury occurs within the alveolar wall. There is proliferation of granulation tissue which involves alveolar ducts and alveoli. Granulation tissue may extend from one alveolus to the adjacent one leading to the formation of mature fibrotic bud which gives characteristic "butterfly" pattern.

Pathophysiology

Pathogenesis

Cryptogenic organizing pneumonia is caused by excessive proliferation of granulation tissue which involves alveolar ducts and alveoli. Granulation tissue may extend from one alveolus to the adjacent one leading to the formation of mature fibrotic bud which gives characteristic "butterfly" pattern.

Various phases involved in the pathogenesis of cryptogenic organizing pneumonia are:[1]

1) Injury phase - The early phase of cryptogenic organizing pneumonia.

2) Proliferating phase - The second stage of the cryptogenic organizing pneumonia in which there is a formation of fibro-inflammatory buds.

3) Mature phase - The third stage is characterized by the formation of mature fibrotic buds which gives characteristic "butterfly" pattern.

4)Resolution phase - The fourth stage, this stage usually resolves if there is the preservation of alveolar basal laminae.

Associated Conditions

Gross Pathology

On gross pathology of cryptogenic organizing pneumonia, following features are seen:

  • There is the firm area with preservation of lung pattern which extends to thickened pleura.[3]

Microscopic Pathology

On microscopic histopathological analysis:[4][5]

source:

References

  1. "American Thoracic Society/European Respiratory Society International Multidisciplinary Consensus Classification of the Idiopathic Interstitial Pneumonias. This joint statement of the American Thoracic Society (ATS), and the European Respiratory Society (ERS) was adopted by the ATS board of directors, June 2001 and by the ERS Executive Committee, June 2001". Am. J. Respir. Crit. Care Med. 165 (2): 277–304. January 2002. doi:10.1164/ajrccm.165.2.ats01. PMID 11790668.
  2. Cordier JF (August 2006). "Cryptogenic organising pneumonia". Eur. Respir. J. 28 (2): 422–46. doi:10.1183/09031936.06.00013505. PMID 16880372.
  3. "Organising pneumonia | Thorax".
  4. "Cryptogenic organising pneumonia | Radiology Reference Article | Radiopaedia.org".
  5. Akyıl FT, Ağca M, Mısırlıoğlu A, Arsev AA, Akyıl M, Sevim T (July 2017). "Organizing Pneumonia as a Histopathological Term". Turk Thorac J. 18 (3): 82–87. doi:10.5152/TurkThoracJ.2017.16047. PMC 5783087. PMID 29404167.

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