Chest X-ray of a 55-year-old female with chronic cough shows multifocal bilateral ground-glass opacities (GGO), predominantly involving the mid and lower lung zones. The opacities are patchy, ill-defined, and non-segmental, without associated lobar consolidation, pleural effusion, or significant volume loss.
These findings are non-specific, raising a differential diagnosis that includes cryptogenic organizing pneumonia (COP), subacute infection, hypersensitivity pneumonitis, and non-specific interstitial pneumonia. Biopsy subsequently confirmed COP, supporting its inclusion as a leading diagnostic consideration in this case.
Ashley Davidoff MD – TheCommonVein.com (140574)
Chest X-ray of a 55-year-old female with chronic cough shows multifocal bilateral ground-glass opacities (GGO), predominantly involving the mid and lower lung zones. The opacities are patchy, ill-defined, and non-segmental, without associated lobar consolidation, pleural effusion, or significant volume loss.
These findings are non-specific, raising a differential diagnosis that includes cryptogenic organizing pneumonia (COP), subacute infection, hypersensitivity pneumonitis, and non-specific interstitial pneumonia. Biopsy subsequently confirmed COP, supporting its inclusion as a leading diagnostic consideration in this case.
Ashley Davidoff MD – TheCommonVein.com (140575)
Axial CT of the chest in a 55-year-old female with biopsy-proven cryptogenic organizing pneumonia (COP) shows interval improvement of prior abnormalities at the same axial level. In the superior segment of the right lower lobe (RLL), there remains a residual ground-glass opacity (GGO), while the previously noted opacity in the inferior lingula has completely resolved.
The patient was treated with a tapering course of corticosteroids, resulting in significant clinical and radiologic improvement over a 10-month period. COP typically responds well to steroid therapy, although mild residual GGO or fibrosis may remain. The differential for these findings includes resolving COP, chronic low-grade inflammation, or early fibrotic remodeling.
Ashley Davidoff MD – TheCommonVein.com (140577)
Axial CT of the chest in a 55-year-old female with chronic cough, imaged near the level as a prior study, shows diffuse ground-glass opacity (GGO) centered in the superior segment of the right lower lobe (RLL) and the inferior lingula. Superimposed findings include bronchovascular bundle thickening and interlobular septal thickening, localized to the secondary pulmonary lobules.
Compared to the prior image, the current section reveals a greater proportion of GGO with less conspicuous ring-like opacity. These findings remain characteristic of cryptogenic organizing pneumonia (COP), though overlap exists with other subacute interstitial processes. The differential diagnosis includes COP, subacute infection, hypersensitivity pneumonitis, and non-specific interstitial pneumonia (NSIP). As previously noted, biopsy confirmed COP in this case.
Ashley Davidoff MD – TheCommonVein.com (140576)
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10 Months Later post Steroid Therapy
Follow-up of Biopsy-Proven COP
Axial CT of the chest in a 55-year-old female with biopsy-proven cryptogenic organizing pneumonia (COP) shows interval improvement of previously noted abnormalities at the same axial level. In the right lower lobe (RLL), there is a residual ground-glass opacity (GGO), consistent with partial resolution. The prior opacity in the inferior lingula has completely resolved.
The patient was treated with a tapering course of corticosteroids, resulting in substantial clinical and radiologic improvement over a 10-month period. COP typically responds well to steroid therapy, though some residual GGO or subtle fibrotic changes may persist. The differential for residual findings includes resolving COP, chronic inflammation, or early fibrotic change.
Ashley Davidoff MD – TheCommonVein.com (140578)
Axial CT of the chest in a 55-year-old female with a history of biopsy-proven cryptogenic organizing pneumonia (COP) shows complete resolution of the previously noted opacity in the inferior lingula. This image, obtained a few cuts inferior to prior sections, confirms the disappearance of lingular involvement.
However, residual ground-glass opacity in the superior segment of the right lower lobe (RLL), as noted on the prior image, remains present. The patient was treated with corticosteroids, with significant improvement over a 10-month period. These findings are consistent with the typical response of COP to therapy. The differential for the residual RLL opacity includes resolving COP, chronic low-grade inflammation, or early fibrotic evolution.
Ashley Davidoff MD – TheCommonVein.com (140579)