Histopathologic variability in usual and nonspecific interstitial pneumonias. Academic Article uri icon

Overview

MeSH

  • Analysis of Variance
  • Diagnosis, Differential
  • Female
  • Humans
  • Male
  • Michigan
  • Middle Aged
  • Prognosis
  • Proportional Hazards Models
  • Pulmonary Fibrosis
  • Survival Rate
  • Tomography, X-Ray Computed

MeSH Major

  • Lung Diseases, Interstitial

abstract

  • Findings of surgical lung biopsy (SLB) are important in categorizing patients with idiopathic interstitial pneumonia (IIP). We investigated whether histologic variability would be evident in SLB specimens from multiple lobes in patients with IIP. SLBs from 168 patients, 109 of whom had multiple lobes biopsied, were reviewed by three pathologists. A diagnosis was assigned to each lobe. A different diagnosis was found between lobes in 26% of the patients. Patients with usual interstitial pneumonia (UIP) in all lobes were categorized as concordant for UIP (n = 51) and those with UIP in at least one lobe were categorized as discordant for UIP (n = 28). Patients with nonspecific interstitial pneumonia (NSIP) in all lobes were categorized as having fibrotic (n = 25) or cellular NSIP (n = 5). No consistent distribution of lobar histology was noted. Patients concordant for UIP were older (63 +/- 9 [mean +/- SD] yr; p < 0.05 as compared with all other groups) than those discordant for UIP (57 +/- 12 yr) or with fibrotic NSIP (56 +/- 11 yr) or cellular NSIP (50 +/- 9 yr). Semiquantitative high-resolution computed tomography demonstrated a varied profusion of fibrosis (p < 0.05 for all group comparisons), with more fibrosis in concordant UIP (2.13 +/- 0.62) than in discordant UIP (1.42 +/- 0.73), fibrotic NSIP (0.83 +/- 0.58), or cellular NSIP (0.44 +/- 0.42). Survival was better for patients with NSIP than for those in both UIP groups (p < 0.001), although survival in the two UIP groups was comparable (p = 0.16). Lobar histologic variability is frequent in patients with IIP, patients with a histologic pattern of UIP in any lobe should be classified as having UIP.

publication date

  • November 1, 2001

has subject area

  • Analysis of Variance
  • Diagnosis, Differential
  • Female
  • Humans
  • Lung Diseases, Interstitial
  • Male
  • Michigan
  • Middle Aged
  • Prognosis
  • Proportional Hazards Models
  • Pulmonary Fibrosis
  • Survival Rate
  • Tomography, X-Ray Computed

Research

keywords

  • Journal Article

Identity

Language

  • eng

Digital Object Identifier (DOI)

  • 10.1164/ajrccm.164.9.2103074

PubMed ID

  • 11719316

Additional Document Info

start page

  • 1722

end page

  • 1727

volume

  • 164

number

  • 9