Idiopathic Interstitial Pneumonias: Diagnostic Accuracy of Thin-Section CT in 129 Patients
RadiologyPublished 1 May 1999
Takeshi Johkoh, Néstor L. Müller, Yannick Cartier, Peter V. Kavanagh, Thomas E. Hartman, Masanori Akira
Citations360
SJR quartileQ1
SJR score3.86
SNIP3.55
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TL;DR
Except for NIPF, the various subtypes of idiopathic interstitial pneumonias often have a characteristic appearance that allows differentiation at thin-section CT.
Abstract
Except for NIPF, the various subtypes of idiopathic interstitial pneumonias often have a characteristic appearance that allows differentiation at thin-section CT.
Keywords
Medicine
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These cases, descriptively termed nonspecific interstitial pneumonia fibrosis, were characterized by varying proportions of interstitial inflammation and fibrosis that appeared to be occurring over a single time span (i.e., the process was temporally uniform.)
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Biochemical studies suggest that the disease of idiopathic pulmonary fibrosis is probably one of collagen rearrangement rather than collagen increase, and peripheral lymphocytes of these patients recognize collagen as "non-self" and, when exposed to it in vitro, produce lymphokines and cell lysis.
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It is concluded that in immunocompetent patients the CT findings in cryptogenic organizing pneumonia most commonly consist of bilateral areas of consolidation involving mainly the subpleural and/or peribronchovascular regions.
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Sixteen cases in which lung biopsies conformed to this general pattern and whose course is known thereafter for at least two years or until death have been reviewed, finding no evident relationship between the histology at the time of biopsy and the total duration of the disease from onset to death.
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Bilateral patchy areas of opacity depicted radiographically and good clinical response to treatment may differentiate NIP from other interstitial pneumonias.
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HRCT findings were not specific for the pathologic findings in patients with acute interstitial pneumonia, Nevertheless, the findings of traction bronchiectasis in areas of increased attenuation suggested the proliferative or fibrotic phase.
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151 Citations1993Steven L. Primack, Thomas E. Hartman +4 more
The authors conclude that the radiographic and CT features of AIP are similar to those of adult respiratory distress syndrome and represent acute alveolar damage.
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The finding of giant-cell interstitial pneumonia is almost pathognomonic of hard-metal disease and should provoke an investigation of occupational exposure.
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The clinical, laboratory, and pathological features of six primary lymphoproliferative conditions of the lung are described and the term 'premalignant lymphoma' be used for pseudolymphoma is recommended since the condition, although tending to remain localised, has a malignant potential.