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A comparative study of honeycombing on high resolution computed tomography with histologic lung remodeling in explants with usual interstitial pneumonia.
Pathol Res Pract. 2015 Jan; 211(1):55-61.PR

Abstract

BACKGROUND

There is little information comparing high-resolution computed tomography (HRCT) findings in UIP with different components that make up remodeling histologically.

DESIGN

We compared histologic features with HRCT scans from 69 explants with UIP. The extent of 7 histologic features were semi-quantitated: respiratory-lined cysts, bronchiolectasis, pulmonary interstitial emphysema (PIE), lobular remodeling, areas resembling non-specific interstitial pneumonia (NSIP), desquamative interstitial pneumonia (DIP)-like pattern, and mucus pooling within cysts extending into surrounding parenchyma. Subpleural cystic spaces and areas of lobular remodeling were measured morphometrically. Histologic features were compared to three findings on HRCT: diagnostic pattern (UIP, probable UIP, or inconsistent with UIP pattern), degree of honeycombing, and degree of ground-glass opacities.

RESULTS

Histologically, respiratory-lined cysts were observed in 78%, bronchiolectasis in 83%, interstitial emphysema in 22%, lobular remodeling in 96%, NSIP-like areas in 87%, DIP-like reaction in 10%, and mucin extravasation in 78%. Morphometrically, cysts of PIE measured 6.2±2.9 mm, respiratory-lined cysts 3.5±2.4 mm, and bronchiolectatic cysts 3.3±1.5 mm. Remodeled lobules measured 3.6±1.1 mm. UIP pattern on CT correlated strongly with histologic extent of bronchiolectasis (p=0.001). HRCT honeycombing showed a positive correlation with histologic bronchiolectasis (p=0.001) and respiratory-lined cysts (p=0.001). GGO was positively associated with NSIP-like areas (p=0.02) and extravasated mucus (p=0.05).

CONCLUSIONS

HRCT findings typical of UIP and HRCT honeycombing correlate best with bronchiolectasis histologically. NSIP pattern is common, and is associated with CT finding of GGO.

Authors+Show Affiliations

Departments of Pathology and Radiology, University of Maryland Medical Center, Baltimore, MD, United States.Departments of Pathology and Radiology, University of Maryland Medical Center, Baltimore, MD, United States.Departments of Pathology and Radiology, University of Maryland Medical Center, Baltimore, MD, United States.Departments of Pathology and Radiology, University of Maryland Medical Center, Baltimore, MD, United States.Departments of Pathology and Radiology, University of Maryland Medical Center, Baltimore, MD, United States.Departments of Pathology and Radiology, University of Maryland Medical Center, Baltimore, MD, United States. Electronic address: allen.burke@gmail.com.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

25433993

Citation

Staats, Paul, et al. "A Comparative Study of Honeycombing On High Resolution Computed Tomography With Histologic Lung Remodeling in Explants With Usual Interstitial Pneumonia." Pathology, Research and Practice, vol. 211, no. 1, 2015, pp. 55-61.
Staats P, Kligerman S, Todd N, et al. A comparative study of honeycombing on high resolution computed tomography with histologic lung remodeling in explants with usual interstitial pneumonia. Pathol Res Pract. 2015;211(1):55-61.
Staats, P., Kligerman, S., Todd, N., Tavora, F., Xu, L., & Burke, A. (2015). A comparative study of honeycombing on high resolution computed tomography with histologic lung remodeling in explants with usual interstitial pneumonia. Pathology, Research and Practice, 211(1), 55-61. https://doi.org/10.1016/j.prp.2014.08.013
Staats P, et al. A Comparative Study of Honeycombing On High Resolution Computed Tomography With Histologic Lung Remodeling in Explants With Usual Interstitial Pneumonia. Pathol Res Pract. 2015;211(1):55-61. PubMed PMID: 25433993.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A comparative study of honeycombing on high resolution computed tomography with histologic lung remodeling in explants with usual interstitial pneumonia. AU - Staats,Paul, AU - Kligerman,Seth, AU - Todd,Nevins, AU - Tavora,Fabio, AU - Xu,Lauren, AU - Burke,Allen, Y1 - 2014/10/22/ PY - 2014/04/08/received PY - 2014/08/09/revised PY - 2014/08/18/accepted PY - 2014/12/1/entrez PY - 2014/12/1/pubmed PY - 2015/10/16/medline KW - High resolution computed tomography KW - Honeycombing KW - Idiopathic pulmonary fibrosis KW - Pathology KW - Pulmonary interstitial emphysema SP - 55 EP - 61 JF - Pathology, research and practice JO - Pathol. Res. Pract. VL - 211 IS - 1 N2 - BACKGROUND: There is little information comparing high-resolution computed tomography (HRCT) findings in UIP with different components that make up remodeling histologically. DESIGN: We compared histologic features with HRCT scans from 69 explants with UIP. The extent of 7 histologic features were semi-quantitated: respiratory-lined cysts, bronchiolectasis, pulmonary interstitial emphysema (PIE), lobular remodeling, areas resembling non-specific interstitial pneumonia (NSIP), desquamative interstitial pneumonia (DIP)-like pattern, and mucus pooling within cysts extending into surrounding parenchyma. Subpleural cystic spaces and areas of lobular remodeling were measured morphometrically. Histologic features were compared to three findings on HRCT: diagnostic pattern (UIP, probable UIP, or inconsistent with UIP pattern), degree of honeycombing, and degree of ground-glass opacities. RESULTS: Histologically, respiratory-lined cysts were observed in 78%, bronchiolectasis in 83%, interstitial emphysema in 22%, lobular remodeling in 96%, NSIP-like areas in 87%, DIP-like reaction in 10%, and mucin extravasation in 78%. Morphometrically, cysts of PIE measured 6.2±2.9 mm, respiratory-lined cysts 3.5±2.4 mm, and bronchiolectatic cysts 3.3±1.5 mm. Remodeled lobules measured 3.6±1.1 mm. UIP pattern on CT correlated strongly with histologic extent of bronchiolectasis (p=0.001). HRCT honeycombing showed a positive correlation with histologic bronchiolectasis (p=0.001) and respiratory-lined cysts (p=0.001). GGO was positively associated with NSIP-like areas (p=0.02) and extravasated mucus (p=0.05). CONCLUSIONS: HRCT findings typical of UIP and HRCT honeycombing correlate best with bronchiolectasis histologically. NSIP pattern is common, and is associated with CT finding of GGO. SN - 1618-0631 UR - https://www.unboundmedicine.com/medline/citation/25433993/A_comparative_study_of_honeycombing_on_high_resolution_computed_tomography_with_histologic_lung_remodeling_in_explants_with_usual_interstitial_pneumonia_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0344-0338(14)00250-7 DB - PRIME DP - Unbound Medicine ER -