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Relationship between histopathological features and the course of idiopathic pulmonary fibrosis/usual interstitial pneumonia.
Thorax. 2006 Dec; 61(12):1091-5.T

Abstract

BACKGROUND

Fibroblastic focus (FF) is the typical histopathological feature of idiopathic pulmonary fibrosis (IPF)/usual interstitial pneumonia (UIP). A study was undertaken to analyse FF at diagnosis, to analyse the histopathological findings at necropsy, and to examine their association with the course of the disease.

METHODS

A retrospective study was made of 76 UIP cases collected over a period of 30 years from one university hospital; 64 had idiopathic IPF. The surface area of one slide of each lung biopsy specimen was defined by image analysis and the total number of FF was quantified. The histological features of necroscopic lung samples were re-analysed in 11 cases. Clinical follow up information was obtained from the registers.

RESULTS

Patients with < or =50 FF/cm(2) (n = 34) in the lung biopsy specimen had a median survival of 89 months (95% CI 38 to 140) compared with 49 months (95% CI 36 to 62) in those with >50 FF/cm(2) (n = 42, p = 0.0358). Diffuse alveolar damage (DAD) was detected in 10 necropsy samples and almost prevented the histopathological confirmation of UIP in six cases. Accumulation of neutrophils occurred in nine cases. There was no association between FF at diagnosis and DAD at necropsy, or between FF and exacerbation of the disease before death.

CONCLUSIONS

The number of FF in lung samples before death is associated with poor survival but not with DAD, which is a common feature in necropsy specimens of patients with UIP. FF cannot predict an acute exacerbation of IPF.

Authors+Show Affiliations

Department of Internal Medicine, University of Oulu, Finland. Leena.Tiitto@oulu.fiNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16769713

Citation

Tiitto, L, et al. "Relationship Between Histopathological Features and the Course of Idiopathic Pulmonary Fibrosis/usual Interstitial Pneumonia." Thorax, vol. 61, no. 12, 2006, pp. 1091-5.
Tiitto L, Bloigu R, Heiskanen U, et al. Relationship between histopathological features and the course of idiopathic pulmonary fibrosis/usual interstitial pneumonia. Thorax. 2006;61(12):1091-5.
Tiitto, L., Bloigu, R., Heiskanen, U., Pääkkö, P., Kinnula, V. L., & Kaarteenaho-Wiik, R. (2006). Relationship between histopathological features and the course of idiopathic pulmonary fibrosis/usual interstitial pneumonia. Thorax, 61(12), 1091-5.
Tiitto L, et al. Relationship Between Histopathological Features and the Course of Idiopathic Pulmonary Fibrosis/usual Interstitial Pneumonia. Thorax. 2006;61(12):1091-5. PubMed PMID: 16769713.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Relationship between histopathological features and the course of idiopathic pulmonary fibrosis/usual interstitial pneumonia. AU - Tiitto,L, AU - Bloigu,R, AU - Heiskanen,U, AU - Pääkkö,P, AU - Kinnula,V L, AU - Kaarteenaho-Wiik,R, Y1 - 2006/06/12/ PY - 2006/6/14/pubmed PY - 2007/1/31/medline PY - 2006/6/14/entrez SP - 1091 EP - 5 JF - Thorax JO - Thorax VL - 61 IS - 12 N2 - BACKGROUND: Fibroblastic focus (FF) is the typical histopathological feature of idiopathic pulmonary fibrosis (IPF)/usual interstitial pneumonia (UIP). A study was undertaken to analyse FF at diagnosis, to analyse the histopathological findings at necropsy, and to examine their association with the course of the disease. METHODS: A retrospective study was made of 76 UIP cases collected over a period of 30 years from one university hospital; 64 had idiopathic IPF. The surface area of one slide of each lung biopsy specimen was defined by image analysis and the total number of FF was quantified. The histological features of necroscopic lung samples were re-analysed in 11 cases. Clinical follow up information was obtained from the registers. RESULTS: Patients with < or =50 FF/cm(2) (n = 34) in the lung biopsy specimen had a median survival of 89 months (95% CI 38 to 140) compared with 49 months (95% CI 36 to 62) in those with >50 FF/cm(2) (n = 42, p = 0.0358). Diffuse alveolar damage (DAD) was detected in 10 necropsy samples and almost prevented the histopathological confirmation of UIP in six cases. Accumulation of neutrophils occurred in nine cases. There was no association between FF at diagnosis and DAD at necropsy, or between FF and exacerbation of the disease before death. CONCLUSIONS: The number of FF in lung samples before death is associated with poor survival but not with DAD, which is a common feature in necropsy specimens of patients with UIP. FF cannot predict an acute exacerbation of IPF. SN - 0040-6376 UR - https://www.unboundmedicine.com/medline/citation/16769713/Relationship_between_histopathological_features_and_the_course_of_idiopathic_pulmonary_fibrosis/usual_interstitial_pneumonia_ L2 - http://thorax.bmj.com/cgi/pmidlookup?view=long&amp;pmid=16769713 DB - PRIME DP - Unbound Medicine ER -