Serial Pulmonary Function Tests in a Patient with Cryptogenic Organizing Pneumonia-A Case Report

Abstract

Cryptogenic organizing pneumonia (COP) is a rare disorder involving the small airways. Polypoid granulation tissues that occupy the lumen of the small airways, alveolar ducts, and alveoli, and foamy macrophages are commonly present in the airspaces. We report an 83-year-old male who had a nonproductive cough for 2 months, after which exertional dyspnea developed. A chest radiograph revealed an infiltration with an irregular reticular pattern with air bronchograms in both lower lungs. Empiric antibiotics failed to improve his dyspnea and hypoxia. Chest computed tomography (CT) revealed peribronchial infiltrates with ground glass opacities in both posterior basal lungs. Wedge lung biopsy resulted in a diagnosis of bronchiolitis obliterans organizing pneumonia. As no etiology could be found, the applicable diagnosis was COP. Oral prednisolone, 1mg/kg/day resulted in dramatic clinical and radiographic improvement. Even after the prednisolone was tapered to 10mg/day, the patient remained asymptomatic with normal daily activity.