{Reference Type}: English Abstract
{Title}: [Clinical analysis of 4 children with cryptogenic organizing pneumonia].
{Author}: Liu CY;Bao YM;Zheng YJ;
{Journal}: Zhonghua Er Ke Za Zhi
{Volume}: 62
{Issue}: 3
{Year}: 2024 Mar 2
暂无{DOI}: 10.3760/cma.j.cn112140-20231102-00341
{Abstract}: Objective: To analyze the clinical features of children with cryptogenic organizing pneumonia (COP) confirmed by pathology. Methods: The clinical manifestations, imaging, pathology, treatment and outcome data of 4 children with COP confirmed by thoracoscopic lung biopsy were retrospectively analyzed, who were hospitalized at Respiratory Department of Shenzhen Children's Hospital from January 2004 to December 2022. Results: All of the 4 patients were male, the age ranged from 1 year 3 months to 14 years. The time from onset to diagnosis was 3 months to 3 years. The follow-up duration was 6 months to 6 years. All the 4 cases had cough, 2 cases had tachypnea and wheezing, 1 case had expectoration, 1 case had chest pain, 1 case had decreased activity tolerance and weight loss. Rales in 2 cases and hypoxemia in 1 case. Pulmonary high resolution CT showed diffuse distribution, involvement of both lungs in 3 cases, and single lung combined migration in 1 case.Three cases showed ground-glass opacity, consolidation, patchy or fibrous strips, and 1 case presented air bronchogram and "reversed halo sign". All the 4 cases were performed thoracoscopic lung biopsy, and the pathological findings showed cellulose exudate or small nodules filled with granulation tissue or fibroblasts in the alveolar cavity and small airways, and 1 case was Masson corpuscle positive. Three patients achieved remission after glucocorticoid therapy. Spontaneous remission without treatment was seen in 1 patient.Two cases were followed up for 17 months and 6 years, respectively, who had excellent outcome. Conclusions: The manifestations of COP in children include cough, expectoration and chest pain. Infants and young children may have tachypnea and wheezing. The most common chest CT findings are diffuse distribution of ground-glass opacity, patchy and consolidation in both lungs. Diagnosis should depend on pathological examination. The effect of glucocorticoid therapy is good.<BR>目的： 分析经病理确诊的隐源性机化性肺炎（COP）患儿的临床特征。 方法： 回顾性分析2004年1月至2022年12月深圳市儿童医院呼吸科经胸腔镜肺活检确诊的4例COP患儿的临床表现、影像、病理、治疗及转归等资料。 结果： 4例COP患儿均为男性，就诊年龄1岁3月龄至14岁，确诊时间3个月至3年，随访时间6个月至6年。4例均有咳嗽症状，气促及喘息2例（均为婴幼儿），咳痰、胸痛各1例，活动耐受性及体重下降1例。体征为干啰音2例、低氧血症1例。肺高分辨CT表现弥漫分布及双肺受累各3例、单肺叶受累并游走性1例。磨玻璃影、实变、斑片或条索影3例，支气管充气征及“反晕征”1例。4例患儿经胸腔镜肺活检，病理显示肺泡腔及小气道内纤维素渗出液或充满肉芽组织或纤维母细胞构成的小结节，Masson小体阳性1例。3例给予糖皮质激素治疗后缓解，1例未治疗自发缓解。失访2例，其余2例患儿分别随访至1年5个月及6年时预后良好。 结论： 儿童COP表现为咳嗽、咳痰、胸痛，婴幼儿有气促或喘息症状，肺CT以双肺弥漫分布的磨玻璃影、斑片影、实变常见，确诊需依靠病理检查。糖皮质激素治疗效果好。.