Relationship between fibroblastic foci profusion and high resolution CT morphology in fibrotic lung disease

Autor: A. Devaraj, Athol U. Wells, David M. Hansell, Simon L.F. Walsh, Jan H. von der Thüsen, Nicola Sverzellati, Samuel A. Yousem, Andrew G. Nicholson, Thomas V. Colby
Přispěvatelé: Pathology
Jazyk: angličtina
Rok vydání: 2015
Předmět:
Fibroblastic foci
Lung Diseases
Male
Pathology
medicine.medical_specialty
PROGNOSIS
Survival
PROTEINS
Interstitial lung disease
Idiopathic pulmonary fibrosis
DIAGNOSIS
CLASSIFICATION
SERUM
Medicine
General & Internal
Usual interstitial pneumonia
General & Internal Medicine
USUAL INTERSTITIAL PNEUMONIA
medicine
Humans
COMPUTED-TOMOGRAPHY
Honeycombing
Aged
Medicine(all)
Bronchiectasis
Lung
Science & Technology
business.industry
General Medicine
11 Medical And Health Sciences
respiratory system
Middle Aged
medicine.disease
Survival Analysis
respiratory tract diseases
medicine.anatomical_structure
CHRONIC HYPERSENSITIVITY PNEUMONITIS
Histopathology
IDIOPATHIC PULMONARY-FIBROSIS
Female
business
Lung Diseases
Interstitial
Tomography
X-Ray Computed
Life Sciences & Biomedicine
Hypersensitivity pneumonitis
Research Article
Zdroj: BMC Medicine
BMC Medicine, 13. BioMed Central Ltd.
ISSN: 1741-7015
Popis: Background: Fibroblastic foci profusion on histopathology and severity of traction bronchiectasis on highresolution computed tomography (HRCT) have been shown to be predictors of mortality in patients with idiopathic pulmonary fibrosis (IPF). The aim of this study was to investigate the relationship between fibroblastic foci (FF) profusion and HRCT patterns in patients with a histopathologic diagnosis of usual interstitial pneumonia (UIP), fibrotic non-specific interstitial pneumonia (NSIP) and chronic hypersensitivity pneumonitis (CHP). Methods: The HRCT scans of 162 patients with a histopathologic diagnosis of UIP or fibrotic NSIP (n = 162) were scored on extent of groundglass opacification, reticulation, honeycombing, emphysema and severity of traction bronchiectasis. For each patient, a fibroblastic foci profusion score based on histopathologic appearances was assigned. Relationships between extent of fibroblastic foci and individual HRCT patterns were investigated using univariate correlation analysis and multivariate linear regression. Results: Increasing extent of reticulation (P < 0.0001) and increasing severity of traction bronchiectasis (P < 0.0001) were independently associated with increasing FF score within the entire cohort. Within individual multidisciplinary team diagnosis subgroups, the only significant independent association with FF score was severity of traction bronchiectasis in patients with idiopathic pulmonary fibrosis (IPF)/UIP (n = 66, r(2) = 0.19, P < 0.0001) and patients with chronic hypersensitivity pneumonitis (CHP) (n = 49, r(2) = 0.45, P < 0.0001). Furthermore, FF score had the strongest association with severity of traction bronchiectasis in patients with IPF (r(2) = 0.34, P < 0.0001) and CHP (r(2) = 0.35, P < 0.0001). There was no correlation between FF score and severity of traction bronchiectasis in patients with fibrotic NSIP. Global disease extent had the strongest association with severity of traction bronchiectasis in patients with fibrotic NSIP (r(2) = 0.58, P < 0.0001). Conclusion: In patients with fibrotic lung disease, profusion of fibroblastic foci is strikingly related to the severity of traction bronchiectasis, particularly in IPF and CHP. This may explain the growing evidence that traction bronchiectasis is a predictor of mortality in several fibrotic lung diseases.
Databáze: OpenAIRE
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