Abstract | OBJECTIVE: MATERIALS AND METHODS: High-resolution CT (HRCT) scans of 44 patients with PAP were evaluated retrospectively with a focus on pulmonary fibrosis: 33 patients had autoimmune PAP, and 11 patients had secondary PAP. The intervals between the initial and last CT examinations ranged from 1 to 284 months (median, 60 months). The HRCT images were assessed by two chest radiologists independently; when the two radiologists disagreed, a final decision was made by consensus. RESULTS: A crazy-paving pattern was a more common HRCT finding in patients with autoimmune PAP than in those with secondary PAP. Traction bronchiectasis was found in four patients (9%) on the initial scans and in 10 patients (23%) on the last scans. There was no honeycombing on the initial scans. Honeycombing developed in two patients (5%): It was detected on 2-year follow-up in one patient and on 6-year follow-up in the other patient. Among the patients with autoimmune PAP, those with fibrosis detected on HRCT during follow-up had a worse prognosis than those without fibrosis detected on HRCT (p = 0.041). CONCLUSION:
Fibrosis develops in approximately 20% of patients with PAP. The CT findings of parenchymal fibrosis suggest a poor outcome.
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Authors | Masanori Akira, Yoshikazu Inoue, Toru Arai, Chikatoshi Sugimoto, Sayoko Tokura, Koh Nakata, Masanori Kitaichi, Osaka Respiratory Diseases Symposia Group |
Journal | AJR. American journal of roentgenology
(AJR Am J Roentgenol)
Vol. 207
Issue 3
Pg. 544-51
(Sep 2016)
ISSN: 1546-3141 [Electronic] United States |
PMID | 27548000
(Publication Type: Journal Article, Multicenter Study)
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Topics |
- Adult
- Aged
- Female
- Humans
- Male
- Middle Aged
- Pulmonary Alveolar Proteinosis
(complications, diagnostic imaging)
- Pulmonary Fibrosis
(diagnostic imaging, etiology)
- Retrospective Studies
- Tomography, X-Ray Computed
(methods)
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