Sestre Milosrdnice University hospital and Institute of Clinical Medical Research
Abstract
Cryptogenic organizing pneumonia is a rare pulmonary disease with characteristic clinical, radiologic and histologic features. The radiologic presentation, and ventilatory and respiratory lung functions reflect the presence of intra-alveolar buds of granulation tissue occurring within the alveoli and alveolar ducts but rarely occupying the bronchiolar lumen. Therefore, it has been accepted that the diagnosis of these characteristic but not specific presentations of cryptogenic organizing pneumonia requires histologic confirmation. The terms cryptogenic organizing pneumonia and idiopathic bronchiolitis obliterans organizing pneumonia are synonyms. There is also secondary organizing pneumonia casually related to various conditions. Presentation is made of two patients with different clinical manifestations of cryptogenic organizing pneumonia: one with low-grade chronic clinical course and migratory inflammatory lung infiltrates, and the other with severe acute clinical manifestations of the disease. In both patients with cryptogenic organizing pneumonia, corticosteroids showed high efficacy for both primary disease and relapses.Kriptogena organizirajuća pneumonija je rijedak entitet u pulmologiji sa znakovitim kliničkim, radiografskim i histološkim manifestacijama. Radiografske manifestacije, kao i ventilacijsku i respiracijsku plućnu funkciju određuju pupoljci granulacijskog tkiva u alveolama i alveolarnim hodnicima, koji se mogu vidjeti i u bronhiolama. Zato je nužna histološka potvrda ovih promjena koje su znakovite, ali ne i specifične za kriptogenu organizirajuću pneumoniju. Kao sinonim za ovu bolest nepoznatog uzroka rabi se i izraz idiopatska (primarna) bronhiolitis obliterans organizirajuća pneumonija. Postoji i sekundarna organizirajuća pneumonija koja ima različite uzroke. Cilj ovoga prikaza je upozoriti na dvije različite manifestacije kriptogene organizirajuće pneumonije: jedna je polagana, kronična, s migrirajućim upalnim infiltratima i blagom kliničkom slikom, a druga akutna s teškom kliničkom slikom. U oba slučaja uslijedio je dobar odgovor na terapiju kortikosteroidima, ali se je javio recidiv koji je također dobro reagirao na ovo liječenje
