Desquamative interstitial pneumonia may progress to lung fibrosis as characterized radiologically.

Abstract

BACKGROUND AND OBJECTIVE:

In some patients, desquamative interstitial pneumonia may progress to lung fibrosis. The aim of this study was to assess the long-term radiological follow-up results in patients with desquamative interstitial pneumonia.

METHODS:

Among 75 patients suspected of having desquamative interstitial pneumonia, 31 who fulfilled the criteria were included in this study. Clinical characteristics at presentation, responses to treatment and long-term follow-up were evaluated.

RESULTS:

The 31 patients were predominantly males (94%), and the mean age was 55 years; 93% (28/30) had a history of smoking. The clinical findings included high serum levels of lactate dehydrogenase and immunoglobulin G. Bronchoalveolar lavage (26 patients, 84% of cases) frequently showed an increased percentage of eosinophils (mean 17%). Computed tomography (CT) or high resolution (HR) CT at presentation showed ground glass opacities and/or consolidation in all patients, with one third of patients also showing thin-walled cysts within the ground glass opacities. There was no honeycombing on CT or HRCT scans at presentation. Corticosteroid therapy was effective early in the course of the disease; long-term follow-up (mean 99 months) of 31 patients showed only one death due to progression of the disease, but long-term follow-up of 14 patients (mean 125 months) by HRCT showed the development of new thin-walled cysts and honeycombing in five and lung cancer in four patients, respectively.

CONCLUSIONS:

In a proportion of patients, desquamative interstitial pneumonia may progress to lung fibrosis with honeycombing on HRCT, despite therapy.

• Authors: Yoshinori Kawabata, Tamiko Takemura, Akira Hebisawa, Yutaka Sugita, Takashi Ogura, Sonoko Nagai, Fumikazu Sakai, Tetsu Kanauchi, Thomas V Colby, Desquamative Interstitial Pneumonia Study Group
• Journal: Respirology (Carlton, Vic.) (Respirology) Vol. 17 Issue 8 Pg. 1214-21 (Nov 2012) ISSN: 1440-1843 [Electronic] Australia
• PMID: 22805187 (Publication Type: Journal Article)
• Copyright: © 2012 The Authors. Respirology © 2012 Asian Pacific Society of Respirology.

Chemical References

• Adrenal Cortex Hormones
• Immunoglobulin G
• L-Lactate Dehydrogenase

Topics

• Adrenal Cortex Hormones (therapeutic use)
• Adult
• Aged
• Bronchoalveolar Lavage Fluid (cytology)
• Disease Progression
• Eosinophils
• Female
• Humans
• Immunoglobulin G (blood)
• L-Lactate Dehydrogenase (blood)
• Lung Diseases, Interstitial (blood, complications, diagnostic imaging, drug therapy, pathology)
• Lung Neoplasms (diagnosis, etiology)
• Male
• Middle Aged
• Pulmonary Fibrosis (blood, diagnostic imaging, etiology, pathology, prevention & control)
• Retrospective Studies
• Smoking (adverse effects)
• Tomography, X-Ray Computed (methods)