Analysis for diagnosis, treatment and chest imaging feature about five cases of pneumoconiosis with organizing pneumonia

Objective To strengthen understanding of the clinical and chest imaging features of pneumoconiosis with organizing pneumonia. Methods The clinical features and diagnosis and therapy process of five cases of pneumoconiosis with organizing pneumonia from Fuzhou Lung Diseases Hospital were analyzed. Results All of five cases were males who had dust contact history.These patients were 29-51 years old.Five patients presented with cough and dyspnea, four cases had fever, and three patients had crackles.As far as laboratory tests, there was one rising white blood cell, five rising C-reactive protein and erythrocyte sedimentation rate, PaO2 was waving from 52.6-77.3 mmHg.Lung function test showed restrictive ventilation dysfunction with diffusion dysfunction in three cases.Chest CT scan showed five cases had bilateral lesions.The main CT manifestations were patch image, consolidation shadow and ground-glass opacity, sometimes accompanying air-bronchogram, and three cases had migration lesions.All of five cases were diagnosed by bronchoscopy biopsy and bronchoalveolar lavage fluid cell classification mainly showed lymphocytes.Methylprednisolone were used in all cases.Two patients conducted noninvasive mechanical ventilation and no patients died. Conclusions When patients who have dust contact history or diagnosed pneumoconiosis have progressive cough and fever, CT manifestations are consolidation shadow or ground-glass opacity accompanying migration sometimes, and no reaction to anti-infection, organizing pneumonia should be considered.Treatment with corticosteroids is optimal, but sometimes likely to relapse. Key words: Pneumoconiosis; Organizing pneumonia; Diagnosis; Clinical feature; Imaging; Treatment