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A Comparison of Histopathological Appearance with Radiological Characteristics of Usual Interstitial Pneumonia

Year 2014, Volume: 3 Issue: 1, 43 - 49, 01.01.2014
https://doi.org/10.5505/abantmedj.2014.04706

Abstract

Histological findings of pulmonary fibrosis correlate strongly with radiological findings on highresolution computed tomography HRCT and pure groundglass attenuation correlates with interstitial inflammation. We aimed to investigate histological correlation with HRCT findings in patients with usual interstitial pneumonia UIP . Method: The records of patients with UIP confirmed with an open lung biopsy were retrospectively reviewed. Duration of symptoms, findings on physical examination, pulmonary function and diffusion test results, and results of arterial blood gas analysis were recorded. Pathology specimens were reexamined by two experienced pathologists for confirmation of the diagnosis taking into consideration ATS/ERS criteria. HRCT images were also reevaluated by a designated radiologist. Clinical, histopathological and radiological findings were recorded and compared. Results: Ten patients had a pathological diagnosis of UIP, all of which also had a microscopic honey comb appearance. Honey comb appearance on HRCT was observed in only 9 patients, 3 of which also had cystic formation. Patients with fibroblastic foci on microscopic examination also had traction bronchiectasis on HRCT. Conclusion: HRCT findings may help predict the presence of microscopic honeycomb appearance and fibroblastic foci consistent with UIP. Duration of symptoms and degree of histological changes are not correlated.

References

  • 1. American Thoracic Society. Idiopathic pulmonary fibrosis: diagnosis and treatment. International consensus statement. American Thoracic Society (ATS), and the European Respiratory Society (ERS). Am J Respir Crit Care Med 2000; 161: 646-664.
  • 2. Müller NL, Guerry-Force ML, Staples CA, Wright JL, Wiggs B, Coppin C et al. Differential diagnosis of bronchiolitis obliterans with organizing pneumonia and usual interstitial pneumonia: clinical, functional, and radiologic findings. Radiology 1987; 162: 151-156.
  • 3. Akira M, Sakatani M, Ueda E. Idiopathic pulmonary fibrosis: progression of honeycombing at thin-section CT. Radiology 1993; 189: 687-691.
  • 4. Kazerooni EA, Martinez FJ, Flint A, Jamadar DA, Gross BH, Spizarny DL, et al. Thin-section CT obtained at 10-mm increments versus limited three-level thin-section CT for idiopathic pulmonary fibrosis: correlation with pathologic scoring. AJR Am J Roentgenol 1997; 169: 977-983.
  • 5. Muller NL, Miller RR, Webb WR, Evans KG, Ostrow DN. Fibrosing alveolitis: CT-pathologic correlation. Radiology 1986; 160: 585-588.
  • 6. Tung KT, Wells AU, Rubens MB, Kirk JM, du Bois RM, Hansell DM. Accuracy of the typical computed tomographic appearances of fibrosing alveolitis. Thorax 1993; 48: 334-338.
  • 7. Chan TY, Hansell DM, Rubens MB, du Bois RM, Wells AU. Cryptogenic fibrosing alveolitis and the fibrosing alveolitis of systemic sclerosis: morphological differences on computed tomographic scans. Thorax 1997; 52: 265-270.
  • 8. Katzenstein AL, Myers JL. Idiopathic pulmonary fibrosis: clinical relevance of pathologic classification. Am J Respir Crit Care Med 1998; 157: 1301-1315.
  • 9. Kanematsu T, Kitaichi M, Nishimura K, Nagai S, Izumi T. Clubbing of the fingers and smooth-muscle proliferation in fibrotic changes in the lung in patients with idiopathic pulmonary fibrosis. Chest 1994; 105: 339-342.
  • 10. Wells AU, Cullinan P, Hansell DM, Rubens MB, Black CM, Newman-Taylor AJ, et al. Fibrosing alveolitis associated with systemic sclerosis has a better prognosis than lone cryptogenic fibrosing alveolitis. Am J Respir Crit Care Med 1994; 149: 1583-1590.
  • 11. Hartman TE, Primack SL, Swensen SJ, Hansell D, McGuinness G, Muller NL. Desquamative interstitial pneumonia: thin-section CT findings in 22 patients. Radiology 1993; 187: 787-790.
  • 12. Coxson HO, Hogg JC, Mayo JR, Behzad H, Whittall KP, Schwartz DA, et al. Quantification of idiopathic pulmonary fibrosis using computed tomography and histology. Am J Respir Crit Care Med 1997; 155: 1649-1656.
  • 13. Collins CD, Wells AU, Hansell DM, Morgan RA, MacSweeney JE, du Bois RM, et al. Observer variation in pattern type and extent of disease in fibrosing alveolitis on thin section computed tomography and chest radiography. Clin Radiol 1994; 49: 236-240.
  • 14. Bergin CJ, Muller NL. CT of interstitial lung disease: a diagnostic approach. AJR Am J Roentgenol 1987; 148: 9-15.
  • 15. Hunninghake GW, Lynch DA, Galvin JR, Gross BH, Müller N, Schwartz DA, et al. Radiologic findings are strongly associated with a pathologic diagnosis of usual interstitial pneumonia. Chest 2003; 124: 1215-1223.
  • 16. Gribbin J, Hubbard RB, Le Jeune I, Smith CJ, West J, Tata LJ. Incidence and mortality of idiopathic pulmonary fibrosis and sarcoidosis in the UK. Thorax 2006; 61: 980–985.
  • 17. Raghu G, Weycker D, Edelsberg J, Bradford WZ, Oster G. Incidence and prevalence of idiopathic pulmonary fibrosis. Am J Respir Crit Care Med 2006; 174: 810–816.
  • 18. Miyake Y, Sasaki S, Yokoyama T, Chida K, Azuma A, Suda T, et al. Occupational and environmental factors and idiopathic pulmonary fibrosis in Japan. Ann Occup Hyg 2005; 49: 259–265.
  • 19. Raghu G, Collard HR, Egan JJ, Martinez FJ, Behr J, Brown KK, et al. ATS/ERS/JRS/ALAT Committee on Idiopathic Pulmonary Fibrosis. An official ATS/ERS/JRS/ALAT statement: idiopathic pulmonary fibrosis: evidence-based guidelines for diagnosis and management. Am J Respir Crit Care Med 2011 Mar 15; 183: 788-824.
  • 20. Travis WD, Costabel U, Hansell DM, King TE Jr, Lynch DA, Nicholson AG et al. ATS/ERS Committee on Idiopathic Interstitial Pneumonias. An official american thoracic society/european respiratory society statement: update of the international multidisciplinary classification of the idiopathic interstitial pneumonias. Am J Respir Crit Care Med. 2013 Sep 15;188(6):733-48.

Usual interstisyel pnömoninin radyolojik özellikleri ile histopatolojik görünümünün karşılaştırılması

Year 2014, Volume: 3 Issue: 1, 43 - 49, 01.01.2014
https://doi.org/10.5505/abantmedj.2014.04706

Abstract

Pulmoner fibrozisin histolojik bulguları, yüksek çözünürlüklü bilgisayarlı tomografideki YRBT radyolojik bulgular ile kuvvetle ilişkilidir ve aynı zamanda buzlu cam görünümü, interstisyel inflamasyon ile ilişkilidir. Biz, usual interstisyel pnömoni UİP olan hastalarda YRBT bulguları ile histolojik korelasyonu araştırmayı amaçladık. Yöntem: Açık akciğer biyopsisi ile UIP tanısı teyit edilen hastaların kayıtları retrospektif olarak incelendi. Semptomların süresi, fizik muayene bulguları, solunum fonksiyon ve difüzyon testi sonuçları ve arteriyel kan gazı analizi sonuçları kaydedildi. İki deneyimli patolog tarafından, tanının teyidi için patoloji örnekleri ATS / ERS kriterleri göz önüne alınarak tekrar incelendi. YRBT görüntüleri de bir radyolog tarafından tekrar değerlendirildi. Klinik, histopatolojik ve radyolojik bulgular kaydedildi ve karşılaştırıldı. Bulgular: UIP patolojik tanısı olan on hastanın hepsinde mikroskobik bal peteği görünümü vardı. HRCT'de bal peteği görünümü 9 hastada gözlendi, bunların 3 tanesinde kistik oluşumda vardı. Mikroskobik incelemede fibroblastik odakları olan hastalarda HRCT'de traksiyon bronşektazisi vardı. Sonuç: YRBT bulguları, UIP’li hastalarda mikroskobik bal peteği görünümünü ve fibroblastik odakların varlığını tahminde yardımcı olabilir. Semptomların süresi ile histolojik değişikliklerin derecesi ilişkili değildir.

References

  • 1. American Thoracic Society. Idiopathic pulmonary fibrosis: diagnosis and treatment. International consensus statement. American Thoracic Society (ATS), and the European Respiratory Society (ERS). Am J Respir Crit Care Med 2000; 161: 646-664.
  • 2. Müller NL, Guerry-Force ML, Staples CA, Wright JL, Wiggs B, Coppin C et al. Differential diagnosis of bronchiolitis obliterans with organizing pneumonia and usual interstitial pneumonia: clinical, functional, and radiologic findings. Radiology 1987; 162: 151-156.
  • 3. Akira M, Sakatani M, Ueda E. Idiopathic pulmonary fibrosis: progression of honeycombing at thin-section CT. Radiology 1993; 189: 687-691.
  • 4. Kazerooni EA, Martinez FJ, Flint A, Jamadar DA, Gross BH, Spizarny DL, et al. Thin-section CT obtained at 10-mm increments versus limited three-level thin-section CT for idiopathic pulmonary fibrosis: correlation with pathologic scoring. AJR Am J Roentgenol 1997; 169: 977-983.
  • 5. Muller NL, Miller RR, Webb WR, Evans KG, Ostrow DN. Fibrosing alveolitis: CT-pathologic correlation. Radiology 1986; 160: 585-588.
  • 6. Tung KT, Wells AU, Rubens MB, Kirk JM, du Bois RM, Hansell DM. Accuracy of the typical computed tomographic appearances of fibrosing alveolitis. Thorax 1993; 48: 334-338.
  • 7. Chan TY, Hansell DM, Rubens MB, du Bois RM, Wells AU. Cryptogenic fibrosing alveolitis and the fibrosing alveolitis of systemic sclerosis: morphological differences on computed tomographic scans. Thorax 1997; 52: 265-270.
  • 8. Katzenstein AL, Myers JL. Idiopathic pulmonary fibrosis: clinical relevance of pathologic classification. Am J Respir Crit Care Med 1998; 157: 1301-1315.
  • 9. Kanematsu T, Kitaichi M, Nishimura K, Nagai S, Izumi T. Clubbing of the fingers and smooth-muscle proliferation in fibrotic changes in the lung in patients with idiopathic pulmonary fibrosis. Chest 1994; 105: 339-342.
  • 10. Wells AU, Cullinan P, Hansell DM, Rubens MB, Black CM, Newman-Taylor AJ, et al. Fibrosing alveolitis associated with systemic sclerosis has a better prognosis than lone cryptogenic fibrosing alveolitis. Am J Respir Crit Care Med 1994; 149: 1583-1590.
  • 11. Hartman TE, Primack SL, Swensen SJ, Hansell D, McGuinness G, Muller NL. Desquamative interstitial pneumonia: thin-section CT findings in 22 patients. Radiology 1993; 187: 787-790.
  • 12. Coxson HO, Hogg JC, Mayo JR, Behzad H, Whittall KP, Schwartz DA, et al. Quantification of idiopathic pulmonary fibrosis using computed tomography and histology. Am J Respir Crit Care Med 1997; 155: 1649-1656.
  • 13. Collins CD, Wells AU, Hansell DM, Morgan RA, MacSweeney JE, du Bois RM, et al. Observer variation in pattern type and extent of disease in fibrosing alveolitis on thin section computed tomography and chest radiography. Clin Radiol 1994; 49: 236-240.
  • 14. Bergin CJ, Muller NL. CT of interstitial lung disease: a diagnostic approach. AJR Am J Roentgenol 1987; 148: 9-15.
  • 15. Hunninghake GW, Lynch DA, Galvin JR, Gross BH, Müller N, Schwartz DA, et al. Radiologic findings are strongly associated with a pathologic diagnosis of usual interstitial pneumonia. Chest 2003; 124: 1215-1223.
  • 16. Gribbin J, Hubbard RB, Le Jeune I, Smith CJ, West J, Tata LJ. Incidence and mortality of idiopathic pulmonary fibrosis and sarcoidosis in the UK. Thorax 2006; 61: 980–985.
  • 17. Raghu G, Weycker D, Edelsberg J, Bradford WZ, Oster G. Incidence and prevalence of idiopathic pulmonary fibrosis. Am J Respir Crit Care Med 2006; 174: 810–816.
  • 18. Miyake Y, Sasaki S, Yokoyama T, Chida K, Azuma A, Suda T, et al. Occupational and environmental factors and idiopathic pulmonary fibrosis in Japan. Ann Occup Hyg 2005; 49: 259–265.
  • 19. Raghu G, Collard HR, Egan JJ, Martinez FJ, Behr J, Brown KK, et al. ATS/ERS/JRS/ALAT Committee on Idiopathic Pulmonary Fibrosis. An official ATS/ERS/JRS/ALAT statement: idiopathic pulmonary fibrosis: evidence-based guidelines for diagnosis and management. Am J Respir Crit Care Med 2011 Mar 15; 183: 788-824.
  • 20. Travis WD, Costabel U, Hansell DM, King TE Jr, Lynch DA, Nicholson AG et al. ATS/ERS Committee on Idiopathic Interstitial Pneumonias. An official american thoracic society/european respiratory society statement: update of the international multidisciplinary classification of the idiopathic interstitial pneumonias. Am J Respir Crit Care Med. 2013 Sep 15;188(6):733-48.
There are 20 citations in total.

Details

Primary Language English
Journal Section Research Article
Authors

Özlem Kar Kurt This is me

Nazire Uçar This is me

Sibel Meryem Alpar This is me

Funda Demirağ This is me

Yetkin Agaçkıran This is me

Hakan Ertürk This is me

Emine Bahar Kurt This is me

Publication Date January 1, 2014
Published in Issue Year 2014 Volume: 3 Issue: 1

Cite

APA Kurt, Ö. K., Uçar, N., Alpar, S. M., Demirağ, F., et al. (2014). A Comparison of Histopathological Appearance with Radiological Characteristics of Usual Interstitial Pneumonia. Abant Medical Journal, 3(1), 43-49. https://doi.org/10.5505/abantmedj.2014.04706
AMA Kurt ÖK, Uçar N, Alpar SM, Demirağ F, Agaçkıran Y, Ertürk H, Kurt EB. A Comparison of Histopathological Appearance with Radiological Characteristics of Usual Interstitial Pneumonia. Abant Med J. January 2014;3(1):43-49. doi:10.5505/abantmedj.2014.04706
Chicago Kurt, Özlem Kar, Nazire Uçar, Sibel Meryem Alpar, Funda Demirağ, Yetkin Agaçkıran, Hakan Ertürk, and Emine Bahar Kurt. “A Comparison of Histopathological Appearance With Radiological Characteristics of Usual Interstitial Pneumonia”. Abant Medical Journal 3, no. 1 (January 2014): 43-49. https://doi.org/10.5505/abantmedj.2014.04706.
EndNote Kurt ÖK, Uçar N, Alpar SM, Demirağ F, Agaçkıran Y, Ertürk H, Kurt EB (January 1, 2014) A Comparison of Histopathological Appearance with Radiological Characteristics of Usual Interstitial Pneumonia. Abant Medical Journal 3 1 43–49.
IEEE Ö. K. Kurt, N. Uçar, S. M. Alpar, F. Demirağ, Y. Agaçkıran, H. Ertürk, and E. B. Kurt, “A Comparison of Histopathological Appearance with Radiological Characteristics of Usual Interstitial Pneumonia”, Abant Med J, vol. 3, no. 1, pp. 43–49, 2014, doi: 10.5505/abantmedj.2014.04706.
ISNAD Kurt, Özlem Kar et al. “A Comparison of Histopathological Appearance With Radiological Characteristics of Usual Interstitial Pneumonia”. Abant Medical Journal 3/1 (January 2014), 43-49. https://doi.org/10.5505/abantmedj.2014.04706.
JAMA Kurt ÖK, Uçar N, Alpar SM, Demirağ F, Agaçkıran Y, Ertürk H, Kurt EB. A Comparison of Histopathological Appearance with Radiological Characteristics of Usual Interstitial Pneumonia. Abant Med J. 2014;3:43–49.
MLA Kurt, Özlem Kar et al. “A Comparison of Histopathological Appearance With Radiological Characteristics of Usual Interstitial Pneumonia”. Abant Medical Journal, vol. 3, no. 1, 2014, pp. 43-49, doi:10.5505/abantmedj.2014.04706.
Vancouver Kurt ÖK, Uçar N, Alpar SM, Demirağ F, Agaçkıran Y, Ertürk H, Kurt EB. A Comparison of Histopathological Appearance with Radiological Characteristics of Usual Interstitial Pneumonia. Abant Med J. 2014;3(1):43-9.