Clinical impact of the radiological indeterminate for usual interstitial pneumonia pattern on the diagnosis of idiopathic pulmonary fibrosis.

Aged Aged, 80 and over Female Humans Idiopathic Pulmonary Fibrosis / diagnostic imaging Lung / diagnostic imaging Lung Diseases, Interstitial / diagnostic imaging Male Middle Aged Radiographic Image Enhancement Retrospective Studies Risk Factors Severity of Illness Index Survival Rate Tomography, X-Ray Computed
Computed tomography Idiopathic interstitial pneumonia Idiopathic pulmonary fibrosis Indeterminate for usual interstitial pneumonia Usual interstitial pneumonia

Journal

Respiratory investigation
ISSN: 2212-5353
Titre abrégé: Respir Investig
Pays: Netherlands
ID NLM: 101581124

Informations de publication

Date de publication:
Jan 2021
Historique:
received: 15 11 2019
revised: 11 07 2020
accepted: 16 07 2020
pubmed: 2 9 2020
medline: 29 6 2021
entrez: 2 9 2020
Statut: ppublish

Résumé

Idiopathic pulmonary fibrosis (IPF) is a fatal lung disease associated with significant morbidity and mortality. The international clinical practice guidelines for the diagnosis of IPF have recently been revised. In this single-center retrospective study conducted between June 2006 and March 2018, 27 patients with a newly classified indeterminate for usual interstitial pneumonia (UIP) pattern on high-resolution computed tomography (HRCT) who had undergone surgical lung biopsy were enrolled at the Japanese Red Cross Medical Center. Clinical and pathological characteristics and prognosis were retrospectively analyzed from patient records. On the basis of multidisciplinary discussion (MDD), IPF was diagnosed in six patients (22%), unclassifiable interstitial pneumonia in 5 (19%), chronic hypersensitivity pneumonitis in 10 (37%), collagen vascular disease-associated interstitial lung disease in 5 (19%), and lymphoproliferative disorder in 1 (4%) patient. Ground-glass opacity, peribronchovascular distribution, upper or middle lobe distribution, mosaic attenuation, consolidation patterns, and honeycombing were found on HRCT. Histological UIP or probable UIP was observed in seven patients. The median survival time from the initial visit was 2770 days (92.3 months). There was a significant difference in survival time in the GAP stage and honeycombing on HRCT according to the log-rank test. Patients with an indeterminate for UIP pattern on HRCT were more likely to have non-IPF than IPF through pathological diagnosis and MDD. GAP stage and honeycombing on HRCT may be significant risk factors for all-cause mortality.

Sections du résumé

BACKGROUND BACKGROUND
Idiopathic pulmonary fibrosis (IPF) is a fatal lung disease associated with significant morbidity and mortality. The international clinical practice guidelines for the diagnosis of IPF have recently been revised.
METHODS METHODS
In this single-center retrospective study conducted between June 2006 and March 2018, 27 patients with a newly classified indeterminate for usual interstitial pneumonia (UIP) pattern on high-resolution computed tomography (HRCT) who had undergone surgical lung biopsy were enrolled at the Japanese Red Cross Medical Center. Clinical and pathological characteristics and prognosis were retrospectively analyzed from patient records.
RESULTS RESULTS
On the basis of multidisciplinary discussion (MDD), IPF was diagnosed in six patients (22%), unclassifiable interstitial pneumonia in 5 (19%), chronic hypersensitivity pneumonitis in 10 (37%), collagen vascular disease-associated interstitial lung disease in 5 (19%), and lymphoproliferative disorder in 1 (4%) patient. Ground-glass opacity, peribronchovascular distribution, upper or middle lobe distribution, mosaic attenuation, consolidation patterns, and honeycombing were found on HRCT. Histological UIP or probable UIP was observed in seven patients. The median survival time from the initial visit was 2770 days (92.3 months). There was a significant difference in survival time in the GAP stage and honeycombing on HRCT according to the log-rank test.
CONCLUSIONS CONCLUSIONS
Patients with an indeterminate for UIP pattern on HRCT were more likely to have non-IPF than IPF through pathological diagnosis and MDD. GAP stage and honeycombing on HRCT may be significant risk factors for all-cause mortality.

Identifiants

DOI: 10.1016/j.resinv.2020.07.001 PMID: 32868263
pubmed: 32868263
pii: S2212-5345(20)30112-X
doi: 10.1016/j.resinv.2020.07.001
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

81-89

Informations de copyright

Copyright © 2020 The Japanese Respiratory Society. Published by Elsevier B.V. All rights reserved.

Déclaration de conflit d'intérêts

Conflict of interest The authors declare that they have no competing interests.

Auteurs

Minoru Inomata (M)

Department of Respiratory Medicine, Japanese Red Cross Medical Center, 4-1-22 Hiroo Shibuya-ku, Tokyo, 150-8935, Japan. Electronic address: inomataminoru@nms.ac.jp.

Tatsunori Jo (T)

Department of Respiratory Medicine, Japanese Red Cross Medical Center, 4-1-22 Hiroo Shibuya-ku, Tokyo, 150-8935, Japan. Electronic address: jotatsunori@gmail.com.

Naoyuki Kuse (N)

Department of Respiratory Medicine, Japanese Red Cross Medical Center, 4-1-22 Hiroo Shibuya-ku, Tokyo, 150-8935, Japan. Electronic address: nao-k-u@nms.ac.jp.

Nobuyasu Awano (N)

Department of Respiratory Medicine, Japanese Red Cross Medical Center, 4-1-22 Hiroo Shibuya-ku, Tokyo, 150-8935, Japan. Electronic address: awanobu0606@hotmail.co.jp.

Mari Tone (M)

Department of Respiratory Medicine, Japanese Red Cross Medical Center, 4-1-22 Hiroo Shibuya-ku, Tokyo, 150-8935, Japan. Electronic address: m.tone.0829@gmail.com.

Hanako Yoshimura (H)

Department of Respiratory Medicine, Japanese Red Cross Medical Center, 4-1-22 Hiroo Shibuya-ku, Tokyo, 150-8935, Japan. Electronic address: mimi-divamariah@live.jp.

Atsuko Moriya (A)

Department of Respiratory Medicine, Japanese Red Cross Medical Center, 4-1-22 Hiroo Shibuya-ku, Tokyo, 150-8935, Japan. Electronic address: atsuko_nms@yahoo.co.jp.

Yuan Bae (Y)

Department of Pathology, Japanese Red Cross Medical Center, 4-1-22 Hiroo Shibuya-ku, Tokyo, 150-8935, Japan. Electronic address: yuan.b.path@gmail.com.

Yuriko Terada (Y)

Department of Thoracic Surgery, Japanese Red Cross Medical Center, 4-1-22 Hiroo Shibuya-ku, Tokyo, 150-8935, Japan. Electronic address: yuriko.terada@gmail.com.

Yoshiaki Furuhata (Y)

Department of Thoracic Surgery, Japanese Red Cross Medical Center, 4-1-22 Hiroo Shibuya-ku, Tokyo, 150-8935, Japan. Electronic address: furuhata-ths@umin.ac.jp.

Toshio Kumasaka (T)

Department of Pathology, Japanese Red Cross Medical Center, 4-1-22 Hiroo Shibuya-ku, Tokyo, 150-8935, Japan. Electronic address: kumasaka_toshio@med.jrc.or.jp.

Ai Ushiwata (A)

Department of Clinical Medicine (Biostatistics), School of Pharmacy at Kitasato University, 5-9-1, Shirokane, Minato-ku, Tokyo, 108-8641, Japan. Electronic address: ushiwataa@pharm.kitasato-u.ac.jp.

Akinori Harada (A)

Department of Radiology, Japanese Red Cross Medical Center, 4-1-22 Hiroo Shibuya-ku, Tokyo, 150-8935, Japan. Electronic address: akinoriharada0428@yahoo.co.jp.

Yasuhiro Terasaki (Y)

Department of Analytic Human Pathology, Graduate School of Medicine, Nippon Medical School, 1-1-5, Sendagi, Bunkyo-ku, Tokyo, 113-8602, Japan. Electronic address: terasaki@nms.ac.jp.

Masahiro Takeuchi (M)

Department of Clinical Medicine (Biostatistics), School of Pharmacy at Kitasato University, 5-9-1, Shirokane, Minato-ku, Tokyo, 108-8641, Japan. Electronic address: tsmasaamg@gmail.com.

Hiroaki Sugiura (H)

Department of Radiology, National Defense Medical College Hospital, 3-2, Namiki, Tokorozawa City, Saitama, 359-8513, Japan. Electronic address: hsugiura@momo.so-net.ne.jp.

Tamiko Takemura (T)

Department of Pathology, Japanese Red Cross Medical Center, 4-1-22 Hiroo Shibuya-ku, Tokyo, 150-8935, Japan; Department of Pathology, Kanagawa Cardiovascular and Respiratory Center, 6-16-1 Tomioka-higashi, Kanazawa-ku, Yokohama City, Kanagawa, 236-0051, Japan. Electronic address: byori@med.jrc.or.jp.

Takehiro Izumo (T)

Department of Respiratory Medicine, Japanese Red Cross Medical Center, 4-1-22 Hiroo Shibuya-ku, Tokyo, 150-8935, Japan. Electronic address: drtake1118@gmail.com.

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questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Sujet âgé › Clinical impact of the radiological...
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questionsmedicales.fr › Maladies de l'appareil respiratoire › Maladies pulmonaires › Pneumopathies interstitielles › Fibrose pulmonaire idiopathique › Clinical impact of the radiological...
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