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Usual interstitial pneumonia end-stage features from explants with radiologic and pathological correlations.
Ann Diagn Pathol. 2015 Aug; 19(4):269-76.AD

Abstract

Idiopathic pulmonary fibrosis (IPF) is the most frequent and severe idiopathic interstitial pneumonia, with typical high-resolution computed tomography (HRCT) features and histologic pattern of usual interstitial pneumonia (UIP); its main differential diagnosis is fibrotic nonspecific interstitial pneumonia (F-NSIP). Usual interstitial pneumonia was mainly described from lung biopsies, and little is known on explants. Twenty-two UIP/IPF explants were analyzed histologically and compared with previous open lung biopsies (OLBs; n = 11) and HRCT (n = 19), when available. Temporospatial heterogeneity and subpleural and paraseptal fibrosis were similarly found in UIP/IPF explants and OLB (91%-95%). Fibroblastic foci were found in 82% of OLBs and 100% of explants, with a higher mean score in explants (P = .023). Honeycombing was present in 64% of OLBs and 95% of explants, with a higher mean score in explants (P = .005). Almost 60% of UIP/IPF explants showed NSIP areas and 41% peribronchiolar fibrosis; inflammation, bronchiolar metaplasia, and vascular changes were more frequent in UIP/IPF explants; and Desquamative Interstitial Pneumonia (DIP)-like areas were not common (18%-27%). Numerous large airspace enlargements with fibrosis were frequent in UIP/IPF explants (59%). On HRCT, honeycombing was observed in 95% of the cases and ground-glass opacities in 53%, correlating with NSIP areas or acute exacerbation at histology. Six patients had combined IPF and emphysema. Lesions were more severe in UIP/IPF explants, reflecting the worsening of the disease. Usual interstitial pneumonia/IPF explants more frequently presented with confounding lesions such as NSIP areas, peribronchiolar fibrosis, and airspace enlargements with fibrosis sometimes associated with emphysema.

Authors+Show Affiliations

Département de Pathologie, Pôle de Biologie et de Pathologie, Centre Hospitalier Universitaire, Inserm U823, Institut A Bonniot-Université J Fourier, Grenoble, France.Centre de Pathologie Est, Hospices Civils de Lyon, Groupement Hospitalier Est, Université Claude Bernard Lyon I, Inserm UMR 754 and IFR 128, Lyon, France.Clinique Universitaire de Radiologie et Imagerie Médicale, Centre Hospitalier Universitaire, Inserm U823, Institut A Bonniot-Université J Fourier, Grenoble, France.Centre de Pathologie Est, Hospices Civils de Lyon, Groupement Hospitalier Est, Université Claude Bernard Lyon I, Inserm UMR 754 and IFR 128, Lyon, France.Clinique Universitaire de Radiologie et Imagerie Médicale, Centre Hospitalier Universitaire, Inserm U823, Institut A Bonniot-Université J Fourier, Grenoble, France.Service de Pneumologie, Centre de référence national des maladies pulmonaires rares, Hospices Civils de Lyon, Hôpital Louis Pradel, Université Claude Bernard Lyon I, UMR754 and IFR128, Lyon, France.Clinique Universitaire de Pneumologie, Pôle Oncologie, Médecine Aiguë et Communautaire, Centre Hospitalier Universitaire, Inserm U1055, Université Joseph Fourier, Grenoble, France.Service de Pneumologie, Centre de référence national des maladies pulmonaires rares, Hospices Civils de Lyon, Hôpital Louis Pradel, Université Claude Bernard Lyon I, UMR754 and IFR128, Lyon, France.Département de Pathologie, Pôle de Biologie et de Pathologie, Centre Hospitalier Universitaire, Inserm U823, Institut A Bonniot-Université J Fourier, Grenoble, France. Electronic address: SLantuejoul@chu-grenoble.fr.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26025258

Citation

Rabeyrin, Maud, et al. "Usual Interstitial Pneumonia End-stage Features From Explants With Radiologic and Pathological Correlations." Annals of Diagnostic Pathology, vol. 19, no. 4, 2015, pp. 269-76.
Rabeyrin M, Thivolet F, Ferretti GR, et al. Usual interstitial pneumonia end-stage features from explants with radiologic and pathological correlations. Ann Diagn Pathol. 2015;19(4):269-76.
Rabeyrin, M., Thivolet, F., Ferretti, G. R., Chalabreysse, L., Jankowski, A., Cottin, V., Pison, C., Cordier, J. F., & Lantuejoul, S. (2015). Usual interstitial pneumonia end-stage features from explants with radiologic and pathological correlations. Annals of Diagnostic Pathology, 19(4), 269-76. https://doi.org/10.1016/j.anndiagpath.2015.05.003
Rabeyrin M, et al. Usual Interstitial Pneumonia End-stage Features From Explants With Radiologic and Pathological Correlations. Ann Diagn Pathol. 2015;19(4):269-76. PubMed PMID: 26025258.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Usual interstitial pneumonia end-stage features from explants with radiologic and pathological correlations. AU - Rabeyrin,Maud, AU - Thivolet,Françoise, AU - Ferretti,Gilbert R, AU - Chalabreysse,Lara, AU - Jankowski,Adrien, AU - Cottin,Vincent, AU - Pison,Christophe, AU - Cordier,Jean-François, AU - Lantuejoul,Sylvie, Y1 - 2015/05/13/ PY - 2015/01/21/received PY - 2015/04/20/revised PY - 2015/05/07/accepted PY - 2015/5/31/entrez PY - 2015/5/31/pubmed PY - 2016/5/14/medline KW - Explant KW - High-resolution computed tomography KW - Lung transplantation KW - Nonspecific interstitial pneumonia KW - Open lung biopsy KW - Pulmonary fibrosis KW - Usual interstitial pneumonia SP - 269 EP - 76 JF - Annals of diagnostic pathology JO - Ann Diagn Pathol VL - 19 IS - 4 N2 - Idiopathic pulmonary fibrosis (IPF) is the most frequent and severe idiopathic interstitial pneumonia, with typical high-resolution computed tomography (HRCT) features and histologic pattern of usual interstitial pneumonia (UIP); its main differential diagnosis is fibrotic nonspecific interstitial pneumonia (F-NSIP). Usual interstitial pneumonia was mainly described from lung biopsies, and little is known on explants. Twenty-two UIP/IPF explants were analyzed histologically and compared with previous open lung biopsies (OLBs; n = 11) and HRCT (n = 19), when available. Temporospatial heterogeneity and subpleural and paraseptal fibrosis were similarly found in UIP/IPF explants and OLB (91%-95%). Fibroblastic foci were found in 82% of OLBs and 100% of explants, with a higher mean score in explants (P = .023). Honeycombing was present in 64% of OLBs and 95% of explants, with a higher mean score in explants (P = .005). Almost 60% of UIP/IPF explants showed NSIP areas and 41% peribronchiolar fibrosis; inflammation, bronchiolar metaplasia, and vascular changes were more frequent in UIP/IPF explants; and Desquamative Interstitial Pneumonia (DIP)-like areas were not common (18%-27%). Numerous large airspace enlargements with fibrosis were frequent in UIP/IPF explants (59%). On HRCT, honeycombing was observed in 95% of the cases and ground-glass opacities in 53%, correlating with NSIP areas or acute exacerbation at histology. Six patients had combined IPF and emphysema. Lesions were more severe in UIP/IPF explants, reflecting the worsening of the disease. Usual interstitial pneumonia/IPF explants more frequently presented with confounding lesions such as NSIP areas, peribronchiolar fibrosis, and airspace enlargements with fibrosis sometimes associated with emphysema. SN - 1532-8198 UR - https://www.unboundmedicine.com/medline/citation/26025258/Usual_interstitial_pneumonia_end_stage_features_from_explants_with_radiologic_and_pathological_correlations_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1092-9134(15)00081-7 DB - PRIME DP - Unbound Medicine ER -