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The Organizing Pneumonias

A Critical Review of Current Concepts and Treatment

  • Review Article
  • Published:
Treatments in Respiratory Medicine

Abstract

In this comprehensive review, two very closely related interstitial pneumonias are discussed: the cryptogenic form of organizing pneumonia (COP); and secondary forms of organizing pneumonia (OP), which occur in association with identifiable medical conditions. Some newer and lesser known of these associated conditions are described, most importantly post-radiation OP.

Rapidly progressive, corticosteroid-resistant and poor prognostic forms of OP have been described. These types purportedly occur more frequently in secondary OP. However, OPs frequently coexist with other interstitial pneumonias, especially when associated with connective tissue diseases. Therefore, tissue sampling error or an incorrect morphologic diagnosis can be the basis for the occurrence of clinically aggressive OPs. By using the 2002 American Thoracic Society/European Respiratory Society diagnostic criteria, some pre-2002 cases reported as OP would be re-classified today.

Although COP is considered to have a good prognosis and to be corticosteroid responsive, approximately 70% of patients, treated with corticosteroids, relapse even during initial treatment. Multiple and late relapses occur in about one-third of the patients. We performed a meta-analysis of second-line treatment options for corticosteroid-refractory forms of OP. Three alternative nonsteroid agents — cyclophosphamide, azathioprine, and cyclosporin — have been used in combination with corticosteroids. On careful review, in a number of cases reported as secondary OP, other histologic interstitial patterns besides OP were described. The need for second-line therapy in these patients might have been dictated by the non-organizing pneumonic component. Most of the scant number of reports come from outside the US. World experience with these is limited, but good clinical outcomes have been noted, even in patients with interstitial patterns in addition to OP.

The initiation of the OP tissue response in the bronchiolar and sub-bronchiolar location may be due to the presence of bronchiolar-associated lymphoid tissue found at the bifurcations of the bronchioles. Inhaled antigens stimulate granulocyte colony stimulating factor-mediated airway inflammation, followed later by CD44-mediated clearance. Repair requires intrabronchiolar formation of granulation tissue and a favorable ratio of matrix metalloproteinase to tissue inhibitors of metalloproteinase (MMP : TIMP) within the stroma. This reparative milieu allows extracellular matrix degradation and re-synthesis to occur. MMP-expressing fibroblasts then phagocytose the collagen fibrils and microfibrils produced earlier in repair, reversing the initial fibrosis.

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References

  1. Epler GR, Colby TV, McLoud TC, et al. Bronchiolitis obliterans organizing pneumonia. N Engl J Med 1985; 312: 152–8

    Article  PubMed  CAS  Google Scholar 

  2. Reynaud A. Memoire sur l’obliteration des bronches. Mem Acad Med (Paris) 1835; 4: 117–67

    Google Scholar 

  3. Kanwar BA, Shehan CJ, Campbell JC, et al. A case of unilateral bronchiolitis obliterans organizing pneumonia (BOOP). Nebr Med J 1996; 81: 149–51

    PubMed  CAS  Google Scholar 

  4. Lange W. Uber eine eigenthumliche: erkrankung der kleinen bronchien und bronchiolen. Dtsch Arch Klin Med 1901; 70: 342–64

    Google Scholar 

  5. Lazor R, Vandevenne A, Pelletier A, et al. Cryptogenic organizing pneumonia: characteristics of relapses in a series of 48 patients. The Groupe d’Etudes et de Recherche sur les Maladies ‘Orphelines’ Pulmonaires (GERM‘O’P). Am J Respir Crit Care Med 2000; 162: 571–7

    Article  CAS  Google Scholar 

  6. Liebow A. Definition and classification of interstitial pneumonias in human pathology. Prog Respir Res 1975; 8: 1–33

    Google Scholar 

  7. Fraser PJ, Paré RG, editors. Obstructive airway disease. 2nd ed. Diagnosis of diseases of the chest. Vol. III. Philadelphia (PA): WB Saunders, 1979: 1298–300

    Google Scholar 

  8. Fraser PJ, Paré RG, editors. Chronic obstructive disease of the lower airways: diagnosis of diseases of the chest. Vol. III. Philadelphia (PA): WB Saunders, 1979: 1461

    Google Scholar 

  9. Cazzato S, Zompatori M, Baruzzi G, et al. Bronchiolitis obliterans-organizing pneumonia: an Italian experience. Respir Med 2000; 94: 702–8

    Article  PubMed  CAS  Google Scholar 

  10. Lohr RH, Boland BJ, Douglas WW, et al. Organizing pneumonia: features and prognosis of cryptogenic, secondary, and focal variants. Arch Intern Med 1997; 157: 1323–9

    Article  PubMed  CAS  Google Scholar 

  11. Chang J, Han J, Kim DW, et al. Bronchiolitis obliterans organizing pneumonia: clinicopathologic review of a series of 45 Korean patients including rapidly progressive form. J Korean Med Sci 2002; 17: 179–86

    PubMed  Google Scholar 

  12. Alasaly K, Muller N, Ostrow DN, et al. Cryptogenic organizing pneumonia: a report of 25 cases and a review of the literature. Medicine (Baltimore) 1995; 74: 201–11

    Article  CAS  Google Scholar 

  13. Davison AG, Heard BE, McAllister WA, et al. Cryptogenic organizing pneumonitis. Q J Med 1983; 52: 382–94

    PubMed  CAS  Google Scholar 

  14. Travis WD, King TE, Bateman ED, et al. ATS/ERS International multidisciplinary consensus classification of idiopathic interstitial pneumonia. Am J Respir Crit Care Med 2002; 165: 277–304

    Article  Google Scholar 

  15. Travis WD, King TE, Bateman ED, et al. Idiopathic interstitial pneumonia and other diffuse parenchymal lung diseases. In: King DW, editor. Non-neoplastic disorder of the lower respiratory tract. Vol. 2. Washington, DC: American Registry of Pathology and Armed Forces Institute of Pathology, 2002

    Google Scholar 

  16. King Jr TE, Mortenson RL. Cryptogenic organizing pneumonitis: the North American experience. Chest 1992; 102: 8S-13S

    Google Scholar 

  17. Cordier JF. Cryptogenic organizing pneumonitis: bronchiolitis obliterans organizing pneumonia. Clin Chest Med 1993; 14: 677–92

    PubMed  CAS  Google Scholar 

  18. Epier GR. Bronchiolitis obliterans organizing pneumonia. Arch Intern Med 2001; 161: 158–64

    Article  Google Scholar 

  19. Nizami IY, Kissner DG, Visscher DW, et al. Idiopathic bronchiolitis obliterans with organizing pneumonia. An acute and life-threatening syndrome. Chest 1995; 108: 271–7

    CAS  Google Scholar 

  20. Watanabe K, Senju S, Wen FQ, et al. Factors related to the relapse of bronchiolitis obliterans organizing pneumonia. Chest 1998; 114: 1599–606

    Article  PubMed  CAS  Google Scholar 

  21. Iwanaga T, Hirota T, Ikeda T. Air leak syndrome as one of the manifestations of bronchiolitis obliterans organizing pneumonia. Intern Med 2000; 39: 163–5

    Article  PubMed  CAS  Google Scholar 

  22. Myers JL, Colby TV. Pathologic manifestations of bronchiolitis, constrictive bronchiolitis, cryptogenic organizing pneumonia, and diffuse panbronchiolitis. Clin Chest Med 1993; 14: 611–22

    PubMed  CAS  Google Scholar 

  23. Inoue T, Toyoshima K, Kikui M. Idiopathic bronchiolitis obliterans organizing pneumonia (idiopathic BOOP) in childhood. Pediatr Pulmonol 1996; 22: 67–72

    Article  PubMed  CAS  Google Scholar 

  24. Kobayashi I, Yamada M, Takahashi Y, et al. Interstitial lung disease associated with juvenile dermatomyositis: clinical features and efficacy of cyclosporin A. Rheumatology (Oxford) 2003; 42: 371–4

    Article  CAS  Google Scholar 

  25. Takada H, Saito Y, Nomura A, et al. Bronchiolitis obliterans organizing pneumonia as an initial manifestation in systemic lupus erythematosus. Pediatr Pulmonol 2005; 40: 257–60

    Article  PubMed  Google Scholar 

  26. Cordier JF, Loire R, Brune J. Idiopathic bronchiolitis obliterans organizing pneumonia: definition of characteristic clinical profiles in a series of 16 patients. Chest 1989; 96: 999–1004

    Article  PubMed  CAS  Google Scholar 

  27. Ichikawa Y, Ninomiya H, Katsuki M, et al. Low-dose/long-term erythromycin for treatment of bronchiolitis obliterans organizing pneumonia (BOOP). Kurume Med J 1993; 40: 65–7

    Article  PubMed  CAS  Google Scholar 

  28. Stover DE, Milite F, Zakowski M. A newly recognized syndrome: radiation-related bronchiolitis obliterans and organizing pneumonia: a case report and literature review. Respiration 2001; 68: 540–4

    Article  PubMed  CAS  Google Scholar 

  29. Mokhtari M, Bach PB, Tietjen PA, et al. Bronchiolitis obliterans organizing pneumonia in cancer: a case series. Respir Med 2002; 96: 280–6

    Article  PubMed  CAS  Google Scholar 

  30. To Y, Sano Y, Sekiya T, et al. Successful treatment of steroid-resistant bronchiolitis obliterans-organizing pneumonia with orally administered cyclosporin and pirfenidone [in Japanese]. Nihon Kokyuki Gakkai Zasshi 2000; 38: 24–9

    PubMed  CAS  Google Scholar 

  31. Katayama H, Yokoyama A, Hamada H, et al. Successful treatment of bronchiolitis obliterans organizing pneumonia with cyclosporin and steroids [in Japanese]. Nihon Kokyuki Gakkai Zasshi 2003; 41: 551–5

    PubMed  Google Scholar 

  32. Katoh T, Ohishi T, Ikuta N, et al. A rapidly progressive case of interstitial pneumonia. Intern Med 1995; 34: 388–92

    Article  PubMed  CAS  Google Scholar 

  33. Epler GR. Bronchiolitis obliterans organizing pneumonia. Semin Respir Infect 1995; 10: 65–77

    PubMed  CAS  Google Scholar 

  34. Cohen AJ, King Jr TE, Downey GP. Rapidly progressive bronchiolitis obliterans with organizing pneumonia. Am J Respir Crit Care Med 1994; 149: 1670–5

    Article  PubMed  CAS  Google Scholar 

  35. Yousem SA, Lohr RH, Colby TV. Idiopathic bronchiolitis obliterans organizing pneumonia/cryptogenic organizing pneumonia with unfavorable outcome: pathologic predictors. Mod Pathol 1997; 10: 864–71

    PubMed  CAS  Google Scholar 

  36. Kondoh Y, Taki F, Ando M, et al. A case of bronchiolitis obliterans organizing pneumonia in a patient with rheumatoid arthritis who responded to corticosteroid and immunosuppressant therapy [in Japanese]. Nihon Kyobu Shikkan Gakkai Zasshi 1992; 30: 1165–70

    PubMed  CAS  Google Scholar 

  37. Ikuta N, Kondoh Y, Taniguchi H, et al. Rapidly progressing BOOP in a patient with positive anti-Jo-1 antibody: response to corticosteroid pulse and immunosuppressant therapy [in Japanese]. Nihon Kyobu Shikkan Gakkai Zasshi 1996; 34: 1156–62

    PubMed  CAS  Google Scholar 

  38. Shinohara T, Hidaka T, Matsuki Y, et al. Rapidly progressive interstitial lung disease associated with dermatomyositis responding to intravenous cyclophosphamide pulse therapy. Intern Med 1997; 36: 519–23

    Article  PubMed  CAS  Google Scholar 

  39. Pommepuy I, Farny M, Billey T, et al. Bronchiolitis obliterans organizing pneumonia in a patient with rheumatoid arthritis. Rev Rheum Engl Ed 1998; 65: 65–7

    CAS  Google Scholar 

  40. Knoell KA, Hook M, Grice DP, et al. Dermatomyositis associated with bronchiolitis obliterans organizing pneumonia (BOOP). J Am Acad Dermatol 1999; 40: 328–30

    Article  PubMed  CAS  Google Scholar 

  41. Takashi S, Okubo Y, Yamazaki Y, et al. Amyopathic dermatomyositis with interstitial pneumonia: effective treatment with cyclophosphamide pulse therapy [in Japanese]. Nihon Kokyuki Gakkai Zasshi 1999; 37: 647–51

    PubMed  CAS  Google Scholar 

  42. Ning-Sheng L, Chun-Liang L, Ray-Sheng L. Bronchiolitis obliterans organizing pneumonia in a patient with Behcet’s disease. Scand J Rheumatol 2004; 33: 437–40

    Article  PubMed  CAS  Google Scholar 

  43. Hsue YT, Paulus HE, Coulson WF. Bronchiolitis obliterans organizing pneumonia in polymyositis: a case report with longterm survival. J Rheumatol 1993; 20: 877–9

    PubMed  CAS  Google Scholar 

  44. Strobel ES, Bonnet RB, Werner P, et al. Bronchiolitis obliterans organising pneumonia and primary biliary cirrhosis-like lung involvement in a patient with primary biliary cirrhosis. Clin Rheumatol 1998; 17: 246–9

    Article  PubMed  CAS  Google Scholar 

  45. Lee YH, Choi SJ, Ji JD, et al. Dermatomyositis without elevation of creatine kinase presented as bronchiolitis obliterans organizing pneumonia. Korean J Intern Med 2000; 15: 85–8

    PubMed  CAS  Google Scholar 

  46. Barzo P, Tuka P, Molnar L, et al. Bronchiolitis obliterans organizing pneumonia: survey based on two cases [in Hungarian]. Orv Hetil 1995; 136: 2231–6

    PubMed  CAS  Google Scholar 

  47. Perez de Llano LA, Soilan JL, Garcia Pais MJ, et al. Idiopathic bronchiolitis obliterans with organizing pneumonia presenting with adult respiratory distress syndrome. Respir Med 1998; 92: 884–6

    Article  PubMed  CAS  Google Scholar 

  48. Koinuma D, Miki M, Ebina M, et al. Successful treatment of a case with rapidly progressive bronchiolitis obliterans organizing pneumonia (BOOP) using cyclosporin A and corticosteroid. Intern Med 2002; 41: 26–9

    Article  PubMed  Google Scholar 

  49. Naccache JM, Faure O, Loire R, et al. Severe hypoxemia with orthodeoxia due to right to left shunt in idiopathic bronchiolitis obliterans organizing pneumonia. Rev Mal Respir 2000; 17: 113–6

    PubMed  CAS  Google Scholar 

  50. Purcell IF, Bourke SJ, Marshall SM. Cyclophosphamide in severe steroid-resistant bronchiolitis obliterans organizing pneumonia. Respir Med 1997; 91: 175–7

    Article  PubMed  CAS  Google Scholar 

  51. Tansey D, Wells AU, Colby TV, et al. Variations in histological patterns of interstitial pneumonia between connective tissue disorders and their relationship to prognosis. Histopathology 2004; 44: 585–96

    Article  PubMed  CAS  Google Scholar 

  52. DeAngelo AJ, Ouellette D. Bronchiolitis obliterans organizing pneumonia in an orthotopic liver transplant patient. Transplantation 2002; 73: 544–6

    Article  PubMed  Google Scholar 

  53. Siddiqui MT, Garrity ER, Husain AN. Bronchiolitis obliterans organizing pneumonia-like reactions: a nonspecific response or an atypical form of rejection or infection in lung allograft recipients? Hum Pathol 1996; 27: 714–9

    Article  PubMed  CAS  Google Scholar 

  54. Kanda Y, Takahashi T, Imai Y, et al. Bronchiolitis obliterans organizing pneumonia after syngeneic bone marrow transplantation for acute lymphoblastic leukemia. Bone Marrow Transplant 1997; 19: 1251–3

    Article  PubMed  CAS  Google Scholar 

  55. Patel M, Ezzat W, Pauw KL, et al. Bronchiolitis obliterans organizing pneumonia in a patient with chronic myelogenous leukemia developing after initiation of interferon and cytosine arabinoside. Eur J Haematol 2001; 67: 318–21

    Article  PubMed  CAS  Google Scholar 

  56. Mendez M, Barriga F, Garcia C, et al. Bronchiolitis obliterans with organizing pneumonia secondary to chemotherapy in a child with primary pericardial sarcoma. Rev Med Chil 2000; 128: 633–40

    Article  PubMed  CAS  Google Scholar 

  57. Morelon E, Stern M, Israel-Biet D, et al. Characteristics of sirolimus-associated interstitial pneumonitis in renal transplant patients. Transplantation 2001; 72: 787–90

    Article  PubMed  CAS  Google Scholar 

  58. Kleindienst R FF, Prior C, Margreiter R, et al. Bronchiolitis obliterans organizing pneumonia associated with Pneumocystis carinii infection in a liver patient receiving tacrolimus. Clin Transplant 1999; 13 (1 Pt 1): 65–7

    Article  PubMed  Google Scholar 

  59. Lee YH, Kim YR, Ji JD, et al. A case of BOOP developed during bucillamine treatment for rheumatoid. Korean J Intern Med 2001; 16: 36–9

    PubMed  CAS  Google Scholar 

  60. Kalambokis G, Stefanou D, Arkoumani E, et al. Bronchiolitis obliterans organizing pneumonia following chlorambucil treatment for chronic lymphocytic leukemia. Eur J Haematol 2004; 73: 139–42

    Article  PubMed  Google Scholar 

  61. Schlesinger C, Veeraraghavan S, Koss MN. Constructive (obliterative) bronchiolitis. Curr Opin Pulm Med 1998; 4: 288–93

    Article  PubMed  CAS  Google Scholar 

  62. Schlesinger C, Meyer CA, Veeraraghavan S, et al. Constrictive (obliterative) bronchiolitis: diagnosis, etiology, and a critical review of the literature. Ann Diagn Pathol 1998; 2: 321–34

    Article  PubMed  CAS  Google Scholar 

  63. Crestani B, Valeyre D, Roden S, et al. Bronchiolitis obliterans organizing pneumonia syndrome primed by radiation therapy to the breast. The Groupe d’Etudes et de Recherche sur les Maladies Orphelines Pulmonaires (GERM‘O’P). Am J Respir Crit Care Med 1998; 158: 1929–35

    Article  CAS  Google Scholar 

  64. Heinrichs D, Amthor M, Kirsten D. Uncommon course of radiation-induced pneumonitis with subsequent bronchiolitis obliterans with organizing pneumonia (BOOP) in a female with breast cancer. Pneumologie 2004; 58: 404–7

    Article  PubMed  CAS  Google Scholar 

  65. Iijima M, Sakahara H. Radiation pneumonitis resembling bronchiolitis obliterans organizing pneumonia after postoperative irradiation for lung cancer: a case report [in Japanese]. Nippon Igaku Hoshasen Gakkai Zasshi 2003; 63: 332–3

    PubMed  Google Scholar 

  66. Takigawa N, Segawa Y, Saeki T, et al. Bronchiolitis obliterans organizing pneumonia syndrome in breast-conserving therapy for early breast cancer: radiation-induced lung toxicity. Int J Radiat Oncol Biol Phys 2000; 48: 751–5

    Article  PubMed  CAS  Google Scholar 

  67. Miwa S, Morita S, Suda T, et al. The incidence and clinical characteristics of bronchiolitis obliterans organizing pneumonia syndrome after radiation therapy for breast cancer. Sarcoidosis Vasc Diffuse Lung Dis 2004; 21: 212–8

    PubMed  Google Scholar 

  68. Schlesinger C, Koss MN. Bronchiolitis: update 2001. Curr Opin Pulm Med 2002; 8: 112–6

    Article  PubMed  Google Scholar 

  69. Moore SL. Bronchiolitis obliterans organizing pneumonia: a late complication of stem cell transplantation. Clin J Oncol Nurs 2003; 7: 659–62

    Article  PubMed  Google Scholar 

  70. Ozawa Y, Ida M, Suda T, et al. Clinical study of bronchiolitis obliterans organizing pneumonia (BOOP) primed by radiation for breast cancer [in Japanese]. Nihon Kokyuki Gakkai Zasshi 2005; 43: 71–6

    PubMed  Google Scholar 

  71. Radzikowska E, Szczepulska E, Chabowski M, et al. Organising pneumonia caused by trastuzumab (Herceptin) therapy for breast cancer. Eur Respir J 2003; 21: 552–5

    Article  PubMed  CAS  Google Scholar 

  72. Hamanishi T, Morimatu T, Oida K, et al. Occurrence of BOOP outside radiation field after radiation therapy for small cell lung cancer [in Japanese]. Nihon Kokyuki Gakkai Zasshi 2001; 39: 683–8

    PubMed  CAS  Google Scholar 

  73. Kwok E, Chan CK. Corticosteroids and azathioprine do not prevent radiation-induced lung injury. Can Respir J 1998; 5: 211–4

    PubMed  CAS  Google Scholar 

  74. Yigla M, Ben-Itzhak O, Solomonov A, et al. Recurrent, self-limited, menstrual-associated bronchiolitis obliterans organizing pneumonia. Chest 2000; 118: 253–6

    Article  PubMed  CAS  Google Scholar 

  75. Ghidini A, Mariani E, Patregnani C, et al. Bronchiolitis obliterans organizing pneumonia in pregnancy. Obstet Gynecol 1999; 94: 843

    Article  PubMed  CAS  Google Scholar 

  76. Timmer SJ, Amundson DE, Malone JD. Hypersensitivity pneumonitis following anthrax vaccination. Chest 2002; 122: 741–5

    Article  PubMed  Google Scholar 

  77. US to stockpile anthrax vaccine for civilians [online]. BBC World News, 2002 June 29. Available from URL: http://news.bbc.co.uk [Accessed 2002 June 29]

  78. Phillips S, Barr S, Dykes N, et al. Bronchiolitis obliterans with organizing pneumonia in a dog. J Vet Intern Med 2000; 14: 204–7

    PubMed  CAS  Google Scholar 

  79. Kim W, Moon CY, Lee HB, et al. A case of bronchiolitis obliterans organizing pneumonia with renal dysfunction after renal transplantation. Clin Nephrol 2001; 55: 412–5

    PubMed  CAS  Google Scholar 

  80. Kanamori H, Mishima A, Tanaka M, et al. Bronchiolitis obliterans organizing pneumonia (BOOP) with suspected liver graft-versus-host disease after allogeneic bone marrow transplantation. Transpl Int 2001; 14: 266–9

    Article  PubMed  CAS  Google Scholar 

  81. Fata F, Rathore R, Schiff C, et al. Bronchiolitis obliterans organizing pneumonia as the first manifestation of polymyositis. South Med J 1997; 90: 227–30

    Article  PubMed  CAS  Google Scholar 

  82. Koss M. Pulmonary lymphoid disorders. Semin Diagn Pathol 1995; 12: 158–71

    PubMed  CAS  Google Scholar 

  83. Popper HH. Bronchiolitis: an update. Virchows Arch 2000; 437: 471–81

    Article  PubMed  CAS  Google Scholar 

  84. Strieter RM. Mechanisms of pulmonary fibrosis: conference summary. Chest 2001; 120: 77S–85S

    Article  PubMed  CAS  Google Scholar 

  85. Usuki J, Fukuda Y. Evolution of three patterns of intra-alveolar fibrosis produced by bleomycin in rats. Pathol Int 1995; 45: 552–64

    Article  PubMed  CAS  Google Scholar 

  86. Poletti V, Castrilli G, Romagna M, et al. Bronchoalveolar lavage, histological and immunohistochemical features in cryptogenic organizing pneumonia. Monaldi Arch Chest Dis 1996; 51: 289–95

    PubMed  CAS  Google Scholar 

  87. Pardo A, Selman M. Matrix metalloproteinases and lung injury. Braz J Med Biol Res 1996; 29: 1109–15

    PubMed  CAS  Google Scholar 

  88. Fukuda Y, Ishizaki M, Kudoh S, et al. Localization of matrix metalloproteinases-1, -2, and -9 and tissue inhibitor of metalloproteinase-2 in interstitial lung diseases. Lab Invest 1998; 78: 687–98

    PubMed  CAS  Google Scholar 

  89. Choi KH, Lee HB, Jeong MY, et al. The role of matrix metalloproteinase-9 and tissue inhibitor of metalloproteinase-1 in cryptogenic organizing pneumonia. Chest 2002; 121: 1478–85

    Article  PubMed  CAS  Google Scholar 

  90. Pardo A, Selman M, Ramirez R, et al. Production of collagenase and tissue inhibitor of metalloproteinases by fibroblasts derived from normal and fibrotic human lungs. Chest 1992; 102: 1085–9

    Article  PubMed  CAS  Google Scholar 

  91. Bouchardy LM, Kuhlman JE, Ball Jr WC, et al. CT findings in bronchiolitis obliterans organizing pneumonia (BOOP) with radiographic, clinical, and histologic correlation. J Comput Assist Tomogr 1993; 17: 352–7

    Article  PubMed  CAS  Google Scholar 

  92. Logan PM, Miller RR, Muller NL. Cryptogenic organizing pneumonia in the immunocompromised patient: radiologic findings and follow-up in 12 patients. Can Assoc Radiol J 1995; 46: 272–9

    PubMed  CAS  Google Scholar 

  93. Oikonomou A, Hansell DM. Organizing pneumonia: the many morphological faces. Eur Radiol 2002; 12: 1486–96

    Article  PubMed  Google Scholar 

  94. Kroegel C, Reibetaig A, Hengst U, et al. Bilateral symmetrical upper-lobe opacities: an unusual presentation of bronchiolitis obliterans organizing pneumonia. Chest 2000; 118: 863–5

    Article  PubMed  CAS  Google Scholar 

  95. Heller I, Biner S, Isakov A, et al. TB or not TB: cavitary bronchiolitis obliterans organizing pneumonia mimicking pulmonary tuberculosis. Chest 2001; 120: 674–8

    Article  PubMed  CAS  Google Scholar 

  96. Muller NL, Guerry-Force ML, Staples CA, et al. Differential diagnosis of bronchiolitis obliterans with organizing pneumonia and usual interstitial pneumonia: clinical, functional, and radiologic findings. Radiology 1987; 162: 151–6

    PubMed  CAS  Google Scholar 

  97. Teel GS, Engeler CE, Tashijian JH, et al. Imaging of small airways disease. Radiographies 1996; 16: 27–41

    CAS  Google Scholar 

  98. Lynch DA. High-resolution CT of idiopathic interstitial pneumonias. Radiol Clin North Am 2001; 39: 1153–70

    Article  PubMed  CAS  Google Scholar 

  99. Muller NL, Staples CA, Miller RR. Bronchiolitis obliterans organizing pneumonia: CT features in 14 patients. AJR Am J Roentgenol 1990; 154: 983–7

    Article  PubMed  CAS  Google Scholar 

  100. Zompatori M, Poletti V, Rimondi MR, et al. Imaging of small airways disease, with emphasis on high resolution computed tomography. Monaldi Arch Chest Dis 1997; 52: 242–8

    PubMed  CAS  Google Scholar 

  101. Tanaka N, Newell JD, Brown KK, et al. Collagen vascular disease-related lung disease: high-resolution computed tomography findings based on the pathologic classification. J Comput Assist Tomogr 2004; 28: 351–60

    Article  PubMed  Google Scholar 

  102. Wittram C. The idiopathic interstitial pneumonias. Curr Probl Diagn Radiol 2004; 33: 189–99

    Article  PubMed  Google Scholar 

  103. Poletti V, Cazzato S, Minicuci N, et al. The diagnostic value of bronchoalveolar lavage and transbronchial lung biopsy in cryptogenic organizing pneumonia. Eur Respir J 1996; 9: 2513–6

    Article  PubMed  CAS  Google Scholar 

  104. Costabel U, Teschler H, Guzman J. Bronchiolitis obliterans organizing pneumonia (BOOP): the cytological and immunocytological profile of bronchoalveolar lavage. Eur Respir J 1992; 5: 791–7

    PubMed  CAS  Google Scholar 

  105. Cordier JF. Organising pneumonia. Thorax 2000; 55: 318–28

    Article  PubMed  CAS  Google Scholar 

  106. Watson D, Fadem Jr JJ. Bronchiolitis obliterans organizing pneumonia cured by standard dose inhaled triamcinolone: the first documented case. South Med J 1995; 88: 980–3

    Article  PubMed  CAS  Google Scholar 

  107. Staud R, Ramos LG. Influenza A-associated bronchiolitis obliterans organizing pneumonia mimicking Wegener’s granulomatosis. Rheumatol Int 2001; 20: 125–8

    Article  PubMed  CAS  Google Scholar 

  108. Egerer G, Witzens M, Spaeth A, et al. Successful treatment of bronchiolitis obliterans organizing pneumonia with low-dose methotrexate in a patient with Hodgkin’s disease. Oncology 2001; 61: 23–7

    Article  PubMed  CAS  Google Scholar 

  109. Cozzi PJ, Hall JB. Cyclophosphamide in the treatment of pulmonary diseases: survey of use, training, and practitioner knowledge base. Chest 1999; 116: 1159–62

    Article  PubMed  CAS  Google Scholar 

  110. Travis WD, King TE, Bateman ED, et al. Connective tissue and inflammatory bowel diseases. In: King DW, editor. Non-neoplastic disorder of the lower respiratory tract. Vol. 2. Washington, DC: American Registry of Pathology and Armed Forces Institute of Pathology, 2002: 306–7

    Google Scholar 

  111. Douglas WW, Tazelaar HD, Hartman TE, et al. Polymyositis-dermatomyositis-associated interstitial lung disease. Am J Respir Crit Care Med 2001; 164: 1182–5

    Article  PubMed  CAS  Google Scholar 

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The authors have no conflicts of interest with a direct bearing on the contents of this article, and no sources of funding were used to assist in the preparation of this review.

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  1. Richmond, Virginia, USA

    Cory Schlesinger

  2. Department of Pathology, University of Southern California, Keck School of Medicine, Hoffman Building, Room 209, 2011 Zonal Avenue, Los Angeles, California, 90033, USA

    Michael N. Koss

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Schlesinger, C., Koss, M.N. The Organizing Pneumonias. Treat Respir Med 5, 193–206 (2006). https://doi.org/10.2165/00151829-200605030-00005

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