HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Arakawa, H. Articles by Kaji, Y. Search for Related Content PubMed PubMed Citation Articles by Arakawa, H. Articles by Kaji, Y. Social Bookmarking                      What's this? Hotlight (NEW!) What's Hotlight?

Progression from Near-Normal to End-Stage Lungs in Chronic Interstitial Pneumonia Related to Silica Exposure: Long-Term CT Observations

¹ Department of Radiology, Dokkyo Medical University School of Medicine, 880 Kita-Kobayashi, Mibu, Utsunomiya, Tochigi 321-0293, Japan.
² Department of Radiology, Kurume University School of Medicine, Kurume City, Japan.
³ Department of Pathology, Dokkyo Medical University School of Medicine, Utsunomiya, Tochigi, Japan.
⁴ Department of Environmental Health, Kochi University School of Medicine, Nankoku, Japan.
⁵ Department of Radiology, Rosai Hospital for Silicosis, Nikko, Japan.
⁶ Department of Respiratory Medicine, Rosai Hospital for Silicosis, Nikko, Japan.

OBJECTIVE. The objective of our study was to evaluate serial CT changes from normal or near-normal lungs to honeycomb lungs in dust-exposed patients who developed chronic interstitial pneumonia.

MATERIALS AND METHODS. From the records of the national hospital for pneumoconiosis, we retrospectively identified patients with chronic interstitial pneumonia who were under surveillance between 1986 and 2006. All patients occasionally underwent chest CT for evaluation of silicosis or exclusion of possible complications. Patients were included in this study only if the initial CT examination did not show obvious chronic interstitial pneumonia. Fourteen patients (all men; median age at initial CT, 58 years) were identified as meeting the inclusion criterion. Two independent reviewers randomly reviewed the CT scans of the study patients to score the extent of ground-glass opacity, reticulation, and honeycombing; to provide a summation of all interstitial opacities (fibrosis score); and to assess coarseness.

RESULTS. Autopsy findings were available for eight of the 14 patients and confirmed the usual interstitial pneumonia (UIP) pattern seen on CT. The median follow-up period was 15.4 years, and none of the patients experienced acute exacerbation. One hundred two CT scans were reviewed. The earliest CT abnormalities included faint ground-glass opacity limited to the lung bases (n = 13) or only coarse reticular opacity (n = 1). In 13 patients, fibrosis and coarseness progressed linearly, whereas the other opacities did not. The annual increase of the fibrosis score and coarseness ranged from 0.306% to 4.633% and 0.179 to 0.479, respectively. Honeycombing developed in all patients over a median period of 12.1 years (range, 3.7–19.1 years).

CONCLUSION. The coarseness best represented the progression of chronic interstitial pneumonia in dust-exposed patients. The earliest CT finding of a UIP pattern in dust-exposed patients was indistinguishable from other types of chronic interstitial pneumonia.

Keywords: chronic interstitial pneumonia • CT • idiopathic pulmonary fibrosis • nonspecific interstitial pneumonia • silicosis • usual interstitial pneumonia pattern

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				J. Behr and V. J. Thannickal Update in Diffuse Parenchymal Lung Disease 2008 Am. J. Respir. Crit. Care Med., March 15, 2009; 179(6): 439 - 444. [Full Text] [PDF]