Giant cell interstitial pneumonia: case series with comprehensive ultrastructural analyses of "not only" hard metal pneumoconiosis.

Autor: Fortarezza F; Surgical Pathology and Cytopathology Unit, University Hospital of Padova, Padova, Italy., Perilli M; Legal Medicine and Toxicology, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy., Della Barbera M; Cardiovascular Pathology Unit, Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padua, Padua, Italy., Pezzuto F; Surgical Pathology and Cytopathology Unit, University Hospital of Padova, Padova, Italy.; Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padua Medical School, Padua, Italy., Faccioli E; Thoracic Surgery Unit; Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padua Medical School, Padua, Italy., Cocconcelli E; Respiratory Disease Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy., Cozzi E; Transplant Immunology Unit, Department of Cardiac, Thoracic and Vascular Sciences and Public Health, Padua University Hospital, Padua, Italy., Somigliana AB; Centro Regionale Microscopia Elettronica, Laboratorio Area Ovest-Settore Laboratori, Agenzia Regionale per la Protezione Ambientale della Lombardia, Milan, Italy., Bonvicini B; Legal Medicine and Toxicology, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy., Rea F; Thoracic Surgery Unit; Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padua Medical School, Padua, Italy., Basso C; Cardiovascular Pathology Unit, Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padua, Padua, Italy., Rizzo S; Cardiovascular Pathology Unit, Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padua, Padua, Italy., Calabrese F; Surgical Pathology and Cytopathology Unit, University Hospital of Padova, Padova, Italy.; Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padua Medical School, Padua, Italy.
Jazyk: angličtina
Zdroj: Histopathology [Histopathology] 2024 Oct 22. Date of Electronic Publication: 2024 Oct 22.
DOI: 10.1111/his.15335
Abstrakt: Aims: Giant cell interstitial pneumonia (GIP) is a fibrosing lung disease histologically characterized by centrilobular pulmonary fibrosis and cannibalistic intra-alveolar multinucleated giant cells. It is considered a form of pneumoconiosis caused particularly by secondary exposure to hard metals (cemented carbide or tungsten carbide). Hard metals are commonly used in various industrial applications, such as cutting tools, drilling tools, machine inserts, and other wear-resistant components. However, cases with unknown exposure that recurred in transplanted lungs have been described. This has led to the hypothesis of a complex etiopathogenesis, likely multifactorial, involving the coparticipation of immune mechanisms. We aimed to identify all the elements present in a series of GIP lung samples to better understand the pathogenic mechanisms of the disease.
Methods and Results: We describe five cases of histologically diagnosed GIP in patients with occupational exposure to metallic dust using ultrastructural characterization to identify metal dust and to quantify asbestos fibres. We found that tungsten was present in three cases, albeit in trace amounts in two of them. Numerous elements were identified in all samples, including asbestos fibres in patients with endstage pulmonary fibrosis. Furthermore, in one of the described cases the recurrence of the disease was also observed in transplanted lungs.
Conclusion: These findings support the hypothesis that GIP may be due to elements other than hard metals, with asbestos possibly representing a contributory factor in the expression of a more severe fibrotic disease. The recurrence of GIP observed in transplanted organs strengthens the hypothesis of the existence of a not yet fully understood etiopathogenic immune mechanism.
(© 2024 John Wiley & Sons Ltd.)
Databáze: MEDLINE
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