BACKGROUND: Hypersensitivity pneumonitis (HP) is an interstitial lung disease caused by the inhalation of environmental antigens. The relationship between clinical, radiologic, and histopathologic findings of chronic HP remains unclear. METHODS: Sixteen patients with proven chronic bird-related HP with a usual interstitial pneumonia-like pattern were analyzed retrospectively. Histopathologic findings were semiquantitatively assessed and compared with clinical and radiologic findings. We also evaluated the histopathologic findings affecting prognosis. RESULTS: The extent of centrilobular fibrosis was negatively correlated with Pao2 (r = -0.55, P = .03). The extent of bridging fibrosis was positively correlated with the ratio of maximal expiratory flow at 50% of forced vital capacity to that at 25% (r = 0.60, P = .02). Patients with a greater extent of fibroblastic foci (FF) had more radiologic reticulation (P = .01), honeycombing (P = .01), and traction bronchiectasis (P = .02), and had significantly shorter survival time (P = .01) than patients with a lesser extent of FF. Multivariate analysis showed that the extent of FF was a significant prognostic factor (hazard ratio, 2.36; 95% confidence interval, 1.02-5.48; P = .04). CONCLUSIONS: Our findings demonstrated that the extent of FF was significantly associated with reticulation, honeycombing, and traction bronchiectasis on high-resolution CT scanning. Moreover, the extent of FF could be a useful predictor of mortality in chronic HP with a usual interstitial pneumonia-like pattern.
BACKGROUND:Hypersensitivitypneumonitis (HP) is an interstitial lung disease caused by the inhalation of environmental antigens. The relationship between clinical, radiologic, and histopathologic findings of chronic HP remains unclear. METHODS: Sixteen patients with proven chronic bird-related HP with a usual interstitial pneumonia-like pattern were analyzed retrospectively. Histopathologic findings were semiquantitatively assessed and compared with clinical and radiologic findings. We also evaluated the histopathologic findings affecting prognosis. RESULTS: The extent of centrilobular fibrosis was negatively correlated with Pao2 (r = -0.55, P = .03). The extent of bridging fibrosis was positively correlated with the ratio of maximal expiratory flow at 50% of forced vital capacity to that at 25% (r = 0.60, P = .02). Patients with a greater extent of fibroblastic foci (FF) had more radiologic reticulation (P = .01), honeycombing (P = .01), and traction bronchiectasis (P = .02), and had significantly shorter survival time (P = .01) than patients with a lesser extent of FF. Multivariate analysis showed that the extent of FF was a significant prognostic factor (hazard ratio, 2.36; 95% confidence interval, 1.02-5.48; P = .04). CONCLUSIONS: Our findings demonstrated that the extent of FF was significantly associated with reticulation, honeycombing, and traction bronchiectasis on high-resolution CT scanning. Moreover, the extent of FF could be a useful predictor of mortality in chronic HP with a usual interstitial pneumonia-like pattern.
Authors: Haruhiko Furusawa; Jonathan H Cardwell; Tsukasa Okamoto; Avram D Walts; Iain R Konigsberg; Jonathan S Kurche; Tami J Bang; Marvin I Schwarz; Kevin K Brown; Jonathan A Kropski; Mauricio Rojas; Carlyne D Cool; Joyce S Lee; Paul J Wolters; Ivana V Yang; David A Schwartz Journal: Am J Respir Crit Care Med Date: 2020-11-15 Impact factor: 21.405
Authors: Margaret L Salisbury; Jeffrey L Myers; Elizabeth A Belloli; Ella A Kazerooni; Fernando J Martinez; Kevin R Flaherty Journal: Am J Respir Crit Care Med Date: 2017-09-15 Impact factor: 21.405
Authors: Margaret L Salisbury; Barry H Gross; Aamer Chughtai; Mohamed Sayyouh; Ella A Kazerooni; Brian J Bartholmai; Meng Xia; Susan Murray; Jeffrey L Myers; Amir Lagstein; Kristine E Konopka; Elizabeth A Belloli; Jamie S Sheth; Eric S White; Colin Holtze; Fernando J Martinez; Kevin R Flaherty Journal: Eur Respir J Date: 2018-08-16 Impact factor: 16.671
Authors: Joseph Jacob; Brian J Bartholmai; Srinivasan Rajagopalan; Maria Kokosi; Ryoko Egashira; Anne Laure Brun; Arjun Nair; Simon L F Walsh; Ronald Karwoski; Athol U Wells Journal: Eur Radiol Date: 2017-09-29 Impact factor: 5.315
Authors: Margaret L Salisbury; Tian Gu; Susan Murray; Barry H Gross; Aamer Chughtai; Mohamed Sayyouh; Ella A Kazerooni; Jeffrey L Myers; Amir Lagstein; Kristine E Konopka; Elizabeth A Belloli; Jamie S Sheth; Eric S White; Colin Holtze; Fernando J Martinez; Kevin R Flaherty Journal: Chest Date: 2018-09-19 Impact factor: 9.410