Tags

Type your tag names separated by a space and hit enter

Variations in histological patterns of interstitial pneumonia between connective tissue disorders and their relationship to prognosis.
Histopathology. 2004 Jun; 44(6):585-96.H

Abstract

AIMS AND METHODS

Pulmonary parenchymal disease is common in patients with connective tissue disorders (CTDs). However, most reports precede recognition of non-specific interstitial pneumonia (NSIP). We have therefore reviewed 54 lung biopsies from 37 patients with polymyositis/dermatomyositis (PM/DM) (n = 13), Sjögren's syndrome (n = 5), rheumatoid arthritis (n = 17) and systemic lupus erythematosus (SLE) (n = 2) to assess the overall and relative frequencies of patterns of interstitial pneumonia and their impact on prognosis.

RESULTS AND CONCLUSIONS

NSIP was the most common pattern with an overall biopsy prevalence of 39% and patient prevalence of 41%. There was variation in prevalence between individual CTDs, with PM/DM commonly showing organizing pneumonia (n = 5), rheumatoid arthritis showing follicular bronchiolitis (n = 6) and Sjögren's syndrome showing chronic bronchiolitis (n = 4). These patterns presented either separately or in association with NSIP, occasionally with different patterns in biopsies from separate lobes. Only four patients showed a pattern of usual interstitial pneumonia (UIP): two with rheumatoid arthritis and one each with PM/DM and SLE. Overall mortality was 24%, the most frequently associated pattern being fibrotic NSIP (n = 5). In nine cases, pulmonary presentation preceded the systemic manifestation of the CTDs. When patients with CTDs present with chronic interstitial lung disease, the most common pattern is NSIP, although there is variation in pattern prevalence between individual disorders and patterns of interstitial pneumonia frequently overlap. These data suggest a different biology for intestitial pneumonias in CTDs when compared with the idiopathic interstitial pneumonias where UIP is the most common pattern. Mortality is similar to that seen in idiopathic NSIP and, coupled with pulmonary presentation occurring prior to the systemic manifestation of disease, this may have a bearing on the origin of some cases of putative idiopathic NSIP.

Authors+Show Affiliations

Department of Histopathology, Royal Brompton Hospital, London, UK.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

15186274

Citation

Tansey, D, et al. "Variations in Histological Patterns of Interstitial Pneumonia Between Connective Tissue Disorders and Their Relationship to Prognosis." Histopathology, vol. 44, no. 6, 2004, pp. 585-96.
Tansey D, Wells AU, Colby TV, et al. Variations in histological patterns of interstitial pneumonia between connective tissue disorders and their relationship to prognosis. Histopathology. 2004;44(6):585-96.
Tansey, D., Wells, A. U., Colby, T. V., Ip, S., Nikolakoupolou, A., du Bois, R. M., Hansell, D. M., & Nicholson, A. G. (2004). Variations in histological patterns of interstitial pneumonia between connective tissue disorders and their relationship to prognosis. Histopathology, 44(6), 585-96.
Tansey D, et al. Variations in Histological Patterns of Interstitial Pneumonia Between Connective Tissue Disorders and Their Relationship to Prognosis. Histopathology. 2004;44(6):585-96. PubMed PMID: 15186274.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Variations in histological patterns of interstitial pneumonia between connective tissue disorders and their relationship to prognosis. AU - Tansey,D, AU - Wells,A U, AU - Colby,T V, AU - Ip,S, AU - Nikolakoupolou,A, AU - du Bois,R M, AU - Hansell,D M, AU - Nicholson,A G, PY - 2004/6/10/pubmed PY - 2004/12/24/medline PY - 2004/6/10/entrez SP - 585 EP - 96 JF - Histopathology JO - Histopathology VL - 44 IS - 6 N2 - AIMS AND METHODS: Pulmonary parenchymal disease is common in patients with connective tissue disorders (CTDs). However, most reports precede recognition of non-specific interstitial pneumonia (NSIP). We have therefore reviewed 54 lung biopsies from 37 patients with polymyositis/dermatomyositis (PM/DM) (n = 13), Sjögren's syndrome (n = 5), rheumatoid arthritis (n = 17) and systemic lupus erythematosus (SLE) (n = 2) to assess the overall and relative frequencies of patterns of interstitial pneumonia and their impact on prognosis. RESULTS AND CONCLUSIONS: NSIP was the most common pattern with an overall biopsy prevalence of 39% and patient prevalence of 41%. There was variation in prevalence between individual CTDs, with PM/DM commonly showing organizing pneumonia (n = 5), rheumatoid arthritis showing follicular bronchiolitis (n = 6) and Sjögren's syndrome showing chronic bronchiolitis (n = 4). These patterns presented either separately or in association with NSIP, occasionally with different patterns in biopsies from separate lobes. Only four patients showed a pattern of usual interstitial pneumonia (UIP): two with rheumatoid arthritis and one each with PM/DM and SLE. Overall mortality was 24%, the most frequently associated pattern being fibrotic NSIP (n = 5). In nine cases, pulmonary presentation preceded the systemic manifestation of the CTDs. When patients with CTDs present with chronic interstitial lung disease, the most common pattern is NSIP, although there is variation in pattern prevalence between individual disorders and patterns of interstitial pneumonia frequently overlap. These data suggest a different biology for intestitial pneumonias in CTDs when compared with the idiopathic interstitial pneumonias where UIP is the most common pattern. Mortality is similar to that seen in idiopathic NSIP and, coupled with pulmonary presentation occurring prior to the systemic manifestation of disease, this may have a bearing on the origin of some cases of putative idiopathic NSIP. SN - 0309-0167 UR - https://www.unboundmedicine.com/medline/citation/15186274/Variations_in_histological_patterns_of_interstitial_pneumonia_between_connective_tissue_disorders_and_their_relationship_to_prognosis_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=0309-0167&date=2004&volume=44&issue=6&spage=585 DB - PRIME DP - Unbound Medicine ER -