Interstitial Pneumonia

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Thomas V Colby - One of the best experts on this subject based on the ideXlab platform.

  • pathologically proved nonspecific Interstitial Pneumonia ct pattern analysis as compared with usual Interstitial Pneumonia ct pattern
    Radiology, 2014
    Co-Authors: Hiromitsu Sumikawa, Thomas V Colby, Takeshi Johkoh, Kiminori Fujimoto, Hiroaki Arakawa, Junya Fukuoka, Hiroyuki Taniguchi, Yasuhiro Kondoh, Kensuke Kataoka, Takashi Ogura
    Abstract:

    Although patients with pathologically proved idiopathic pulmonary fibrosis/usual Interstitial Pneumonia showed variable CT patterns, those with pathologically proved nonspecific Interstitial Pneumonia showed less variable CT patterns.

  • acute exacerbation of Interstitial Pneumonia other than idiopathic pulmonary fibrosis
    Chest, 2007
    Co-Authors: Inae Park, Tae Sun Shim, Se Jin Jang, Thomas V Colby
    Abstract:

    Backgrounds: Acute exacerbation (AE) in idiopathic pulmonary fibrosis (IPF) is increasingly recognized as a relatively common and highly morbid clinical event. However, clinical data on AE in non-IPF Interstitial Pneumonia are sparse. This study was performed to find the frequency, clinical features, and outcome of AE in non-IPF Interstitial Pneumonia. Methods: Retrospective analysis of 10 patients who satisfied the modified Akira criteria for AE during follow-up of 74 patients with surgical lung biopsy-confirmed idiopathic nonspecific Interstitial Pneumonia (I-NSIP) and 93 patients with biopsy-confirmed Interstitial Pneumonia associated with collagen vascular disease (CVD-IP). Results: AE occurred in six patients with I-NSIP (1-year frequency, 4.2%) and in four patients with CVD-IP (rheumatoid arthritis [RA], n = 3; scleroderma, n = 1), with 1-year frequency of 3.3%. Median age was 58 years (range, 47 to 75); six patients were female. AE occurred in two patients immediately after surgical biopsy. Median duration of acute symptom before hospital admission was 10 days (range, 1 to 30). Median ratio of Pa o 2 to the fraction of inspired oxygen (F io 2 ) was 172 (range, 107 to 273), and Pa o 2 /F io 2 ratio was Conclusion: AE occurred in the patients with I-NSIP with apparently better prognosis. In patients with CVD-IP, AE occurred mostly with RA-usual Interstitial Pneumonia in our small series with poor outcome.

  • physiology is a stronger predictor of survival than pathology in fibrotic Interstitial Pneumonia
    American Journal of Respiratory and Critical Care Medicine, 2005
    Co-Authors: Yangjin Jegal, Masanori Kitaichi, William D Travis, Tae Sun Shim, Thomas V Colby
    Abstract:

    The histopathologic pattern provides the most important prognostic marker for idiopathic Interstitial Pneumonia; however, studies have suggested that short-term changes in lung function may be more important. We investigated the prognostic factors for fibrotic Interstitial Pneumonia. The clinical features and follow-up course of 179 patients (131 with idiopathic pulmonary fibrosis and 48 with nonspecific Interstitial Pneumonia; 41 fibrotic types and 7 cellular) were analyzed retrospectively. The lung function indices improved or stabilized in most patients with fibrotic nonspecific Interstitial Pneumonia in contrast to the deterioration or stable condition of most patients with idiopathic pulmonary fibrosis. The 5-year survival of patients with fibrotic nonspecific Interstitial Pneumonia (76.2%) was better than for those with idiopathic pulmonary fibrosis (43.8%) (p = 0.007). Multivariate analysis at the time of presentation revealed that pathologic pattern, age, and diffusion capacity had important prognostic implications. However, after 6 months of follow-up, changes in FVC, initial diffusion capacity, and sex were the only independent prognostic factors, with no additional prognostic information conferred by the histologic diagnosis. Our data confirmed the importance of physiological parameters including short-term change in FVC. However, at the time of diagnosis, histopathology was important for the prediction of prognosis and future change in lung function.

  • prognostic value of desaturation during a 6 minute walk test in idiopathic Interstitial Pneumonia
    American Journal of Respiratory and Critical Care Medicine, 2003
    Co-Authors: Vibha N Lama, Kevin R Flaherty, Thomas V Colby, William D Travis, Susan Murray, Ella A Kazerooni, Barry H Gross, Galen B Toews, Qi Long, Joseph P Lynch
    Abstract:

    Exercise-induced hypoxia is an index of the severity of Interstitial lung disease. We hypothesized that desaturation during a 6-minute walk test would predict mortality for patients with usual Interstitial Pneumonia (n 83) and nonspecific Interstitial Pneumonia (n 22). Consecutive patients with biopsy-proven disease performed a 6-minute walk test between January 1996 and December 2001. Desaturation was defined as a fall in oxygen saturation to 88% or less during the 6-minute walk test. Desaturation was common (44 of 83 usual Interstitial Pneumonia and 8 of 22 nonspecific Interstitial Pneumonia; chi square, p 0.39). Patients with usual Interstitial Pneumonia or nonspecific Interstitial Pneumonia who desaturated had a significantly higher mortality than patients who did not desaturate (respective log-rank tests, p 0.0018, p 0.0089). In patients with usual Interstitial Pneumonia, the presence of desaturation was associated with an increased hazard of death (hazard ratio, 4.2; 95% confidence interval, 1.40, 12.56; p 0.01) after adjusting for age, sex, smoking, baseline diffusion capacity for carbon monoxide, FVC, and resting saturation. We conclude that knowledge of desaturation during a 6-minute walk test adds prognostic information for

  • prognostic implications of physiologic and radiographic changes in idiopathic Interstitial Pneumonia
    American Journal of Respiratory and Critical Care Medicine, 2003
    Co-Authors: Kevin R Flaherty, Thomas V Colby, William D Travis, Jeanette A Mumford, Susan Murray, Ella A Kazerooni, Barry H Gross, Andrew Flint, Galen B Toews, Joseph P Lynch
    Abstract:

    Idiopathic Interstitial Pneumonias are a diverse group of lung diseases with varied prognoses. We hypothesized that changes in physiologic and radiographic parameters would predict survival. We retrospectively examined 80 patients with usual Interstitial Pneumonia and 29 patients with nonspecific Interstitial Pneumonia. Baseline characteristics were examined together with 6-month change in forced vital capacity, diffusing capacity for carbon monoxide, and ground glass infiltrate and fibrosis on high resolution computed tomography. Patients with usual Interstitial Pneumonia were more likely to have a statistically significant or marginally significant decline in lung volume, diffusing capacity for carbon monoxide, and an increase in ground glass infiltrates (p ⩽ 0.08) compared with patients with nonspecific Interstitial Pneumonia. For patients with usual Interstitial Pneumonia, change in forced vital capacity was the best physiologic predictor of mortality (p = 0.05). In a multivariate Cox proportional haz...

Takeshi Johkoh - One of the best experts on this subject based on the ideXlab platform.

  • pathologically proved nonspecific Interstitial Pneumonia ct pattern analysis as compared with usual Interstitial Pneumonia ct pattern
    Radiology, 2014
    Co-Authors: Hiromitsu Sumikawa, Thomas V Colby, Takeshi Johkoh, Kiminori Fujimoto, Hiroaki Arakawa, Junya Fukuoka, Hiroyuki Taniguchi, Yasuhiro Kondoh, Kensuke Kataoka, Takashi Ogura
    Abstract:

    Although patients with pathologically proved idiopathic pulmonary fibrosis/usual Interstitial Pneumonia showed variable CT patterns, those with pathologically proved nonspecific Interstitial Pneumonia showed less variable CT patterns.

  • Nonspecific Interstitial Pneumonia and usual Interstitial Pneumonia: is differentiation possible by high-resolution computed tomography?
    Seminars in Ultrasound Ct and Mri, 2013
    Co-Authors: Takeshi Johkoh
    Abstract:

    Abstract Nonspecific Interstitial Pneumonia (NSIP) is a form of idiopathic Interstitial Pneumonia characterized histologically by varying degrees of Interstitial inflammation and fibrosis that are temporally and morphologically homogeneous in comparison with usual Interstitial Pneumonia (UIP). Differentiation from UIP is very important because treatment and prognosis are different between NSIP and UIP. Although there are limitations for the differentiation between NSIP and UIP on computed tomography, some computed tomography findings contribute to it. Relatively peribronchovascular distribution, wide extent of areas with ground-glass attenuation, and subpleural sparing are more highly seen in patients with NSIP, whereas wide extent of honeycombing and subpleural distribution are more common characteristics in patients with UIP.

  • acute Interstitial Pneumonia
    American Journal of Respiratory and Critical Care Medicine, 2012
    Co-Authors: Kazuya Ichikado, Takeshi Johkoh, Hiroyuki Taniguchi, Yasuhiro Kondoh, Moritaka Suga, Nestor L Muller, Masanori Akira, Naoki Mihara, Hironobu Nakamura, Mutsumasa Takahashi
    Abstract:

    This study compared high-resolution computed tomography (CT) findings between 10 survivors and 21 nonsurvivors of acute Interstitial Pneumonia and evaluated whether the CT findings were predictive of patients' response to treatment. The survivor and nonsurvivor groups with pathologically or clinically diagnosed acute Interstitial Pneumonia were similar in age, sex, disease duration, and lung injury score. Retrospective, subjective evaluations of the CT scans were conducted by two independent observers without knowledge of patient outcomes. CT findings were graded on a one to six scale corresponding to consecutive pathologic phases as follows: areas of (1) normal attenuation, (2) ground-glass attenuation, (3) consolidation, (4) ground-glass attenuation associated with traction bronchiolectasis or bronchiectasis, (5) consolidation associated with traction bronchiolectasis or bronchiectasis, and (6) honeycombing. An overall score was obtained by quantifying the extent of each abnormality in three lung zones ...

  • usual Interstitial Pneumonia and chronic idiopathic Interstitial Pneumonia analysis of ct appearance in 92 patients
    Radiology, 2006
    Co-Authors: Hiromitsu Sumikawa, Takeshi Johkoh, Kiminori Fujimoto, Hiroyuki Taniguchi, Yasuhiro Kondoh, Kazuya Ichikado, Ukihide Tateishi, Tetsuo Hiramatsu, Atsuo Inoue, Javzandulam Natsag
    Abstract:

    PURPOSE: To retrospectively analyze computed tomographic (CT) findings of chronic idiopathic Interstitial Pneumonia (IIP) and to determine which findings are most helpful for distinguishing IIP from usual Interstitial Pneumonia (UIP) with univariate and multivariate analyses. MATERIALS AND METHODS: Institutional review board approval and informed consent were not required for this retrospective review of patient records and images. Two observers working independently and without knowledge of the diagnosis evaluated the extent and distribution of various thin-section CT findings (ground-glass opacity, consolidation, reticulation, and honeycombing) in 92 patients (51 men, 41 women; mean age, 56 years; age range, 29-81 years) with a histologic diagnosis of UIP (n = 20), cellular nonspecific Interstitial Pneumonia (NSIP) (n = 16), fibrotic NSIP (n = 16), respiratory bronchiolitis-associated Interstitial lung disease (RB-ILD) (n = 11), desquamative Interstitial Pneumonia (DIP) (n = 15), or lymphoid Interstitial Pneumonia (LIP) (n = 14). Observers used univariate and multivariate statistical analyses to compare their findings with the extent and distribution of UIP. RESULTS: Observers made the correct diagnosis in 145 (79%) of 184 readings. Multivariate logistic regression analysis showed that the independent findings that distinguished UIP from cellular NSIP were the extent of honeycombing and the most proximal bronchus with traction bronchiectasis (odds ratio, 5.16 and 0.37, respectively); the finding that distinguished UIP from fibrotic NSIP was the extent of honeycombing (odds ratio, 2.10). CT features that distinguished UIP from RB-ILD and DIP included extent of ground-glass opacity (odds ratio, 0.76), thickening of bronchovascular bundles (odds ratio, 1.58), the most proximal bronchus with traction bronchiectasis (odds ratio, 0.22), and the number of segments with traction bronchiectasis (odds ratio, 3.64). CONCLUSION: UIP has a characteristic appearance that usually facilitates distinction from other types of chronic IIPs at thin-section CT. The most useful finding when differentiating UIP from NSIP was the extent of honeycombing.

  • acute exacerbation of Interstitial Pneumonia following surgical lung biopsy
    Respiratory Medicine, 2006
    Co-Authors: Yasuhiro Kondoh, Masanori Kitaichi, Takeshi Johkoh, Hiroyuki Taniguchi, Toyoharu Yokoi, Takashi Oishi, Tomoki Kimura, Osamu Nishiyama, Keisuke Kato, Roland M. Du Bois
    Abstract:

    Summary Study objectives Surgical lung biopsy (SLB) plays an important role in the diagnosis of Interstitial Pneumonia, however, the occurrence of acute respiratory failure following SLB remains largely unreported. We evaluated the incidence, clinical features, therapy and prognosis of acute exacerbation of Interstitial Pneumonia following SLB. Design Retrospective study of consecutive patients who underwent SLB to establish a diagnosis of diffuse lung disease between May 1989 and April 2000. Patients with an acute exacerbation following lung biopsy were studied, and the HRCT images of the chest before and after surgery were reviewed. Measurements and results Among the 236 consecutive patients with Interstitial Pneumonia who underwent a surgical lung biopsy, five (2.1%) (IPF, 3; NSIP, 1; COP, 1) developed acute exacerbation of the diffuse lung disease in the course of 1–18 days after SLB. The extent of parenchymal involvement on HRCT before surgery was not significantly different between operated and contralateral nonoperated lung. Significantly increased regions of parenchymal involvement on HRCT were seen postoperatively compared with the preoperative CT in both the operated (20.7±12.5% versus 38.2±10.8%, P = 0.0431 ) and nonoperated lung (22.7±13.8% versus 70.5±24.4%, P = 0.0431 ), but the extent of the parenchymal involvement was significantly greater on the nonoperated side ( P = 0.0251 ). Two of the 3 IPF patients died from the acute exacerbation. Conclusions It is important to be aware of the possibility of acute exacerbation of Interstitial Pneumonia following SLB even after an apparently uneventful immediate postoperative course. The asymmetric image findings suggest that intraoperative respiratory management is a possible etiologic factor.

Yasuhiro Kondoh - One of the best experts on this subject based on the ideXlab platform.

  • pathologically proved nonspecific Interstitial Pneumonia ct pattern analysis as compared with usual Interstitial Pneumonia ct pattern
    Radiology, 2014
    Co-Authors: Hiromitsu Sumikawa, Thomas V Colby, Takeshi Johkoh, Kiminori Fujimoto, Hiroaki Arakawa, Junya Fukuoka, Hiroyuki Taniguchi, Yasuhiro Kondoh, Kensuke Kataoka, Takashi Ogura
    Abstract:

    Although patients with pathologically proved idiopathic pulmonary fibrosis/usual Interstitial Pneumonia showed variable CT patterns, those with pathologically proved nonspecific Interstitial Pneumonia showed less variable CT patterns.

  • acute Interstitial Pneumonia
    American Journal of Respiratory and Critical Care Medicine, 2012
    Co-Authors: Kazuya Ichikado, Takeshi Johkoh, Hiroyuki Taniguchi, Yasuhiro Kondoh, Moritaka Suga, Nestor L Muller, Masanori Akira, Naoki Mihara, Hironobu Nakamura, Mutsumasa Takahashi
    Abstract:

    This study compared high-resolution computed tomography (CT) findings between 10 survivors and 21 nonsurvivors of acute Interstitial Pneumonia and evaluated whether the CT findings were predictive of patients' response to treatment. The survivor and nonsurvivor groups with pathologically or clinically diagnosed acute Interstitial Pneumonia were similar in age, sex, disease duration, and lung injury score. Retrospective, subjective evaluations of the CT scans were conducted by two independent observers without knowledge of patient outcomes. CT findings were graded on a one to six scale corresponding to consecutive pathologic phases as follows: areas of (1) normal attenuation, (2) ground-glass attenuation, (3) consolidation, (4) ground-glass attenuation associated with traction bronchiolectasis or bronchiectasis, (5) consolidation associated with traction bronchiolectasis or bronchiectasis, and (6) honeycombing. An overall score was obtained by quantifying the extent of each abnormality in three lung zones ...

  • usual Interstitial Pneumonia and chronic idiopathic Interstitial Pneumonia analysis of ct appearance in 92 patients
    Radiology, 2006
    Co-Authors: Hiromitsu Sumikawa, Takeshi Johkoh, Kiminori Fujimoto, Hiroyuki Taniguchi, Yasuhiro Kondoh, Kazuya Ichikado, Ukihide Tateishi, Tetsuo Hiramatsu, Atsuo Inoue, Javzandulam Natsag
    Abstract:

    PURPOSE: To retrospectively analyze computed tomographic (CT) findings of chronic idiopathic Interstitial Pneumonia (IIP) and to determine which findings are most helpful for distinguishing IIP from usual Interstitial Pneumonia (UIP) with univariate and multivariate analyses. MATERIALS AND METHODS: Institutional review board approval and informed consent were not required for this retrospective review of patient records and images. Two observers working independently and without knowledge of the diagnosis evaluated the extent and distribution of various thin-section CT findings (ground-glass opacity, consolidation, reticulation, and honeycombing) in 92 patients (51 men, 41 women; mean age, 56 years; age range, 29-81 years) with a histologic diagnosis of UIP (n = 20), cellular nonspecific Interstitial Pneumonia (NSIP) (n = 16), fibrotic NSIP (n = 16), respiratory bronchiolitis-associated Interstitial lung disease (RB-ILD) (n = 11), desquamative Interstitial Pneumonia (DIP) (n = 15), or lymphoid Interstitial Pneumonia (LIP) (n = 14). Observers used univariate and multivariate statistical analyses to compare their findings with the extent and distribution of UIP. RESULTS: Observers made the correct diagnosis in 145 (79%) of 184 readings. Multivariate logistic regression analysis showed that the independent findings that distinguished UIP from cellular NSIP were the extent of honeycombing and the most proximal bronchus with traction bronchiectasis (odds ratio, 5.16 and 0.37, respectively); the finding that distinguished UIP from fibrotic NSIP was the extent of honeycombing (odds ratio, 2.10). CT features that distinguished UIP from RB-ILD and DIP included extent of ground-glass opacity (odds ratio, 0.76), thickening of bronchovascular bundles (odds ratio, 1.58), the most proximal bronchus with traction bronchiectasis (odds ratio, 0.22), and the number of segments with traction bronchiectasis (odds ratio, 3.64). CONCLUSION: UIP has a characteristic appearance that usually facilitates distinction from other types of chronic IIPs at thin-section CT. The most useful finding when differentiating UIP from NSIP was the extent of honeycombing.

  • acute exacerbation of Interstitial Pneumonia following surgical lung biopsy
    Respiratory Medicine, 2006
    Co-Authors: Yasuhiro Kondoh, Masanori Kitaichi, Takeshi Johkoh, Hiroyuki Taniguchi, Toyoharu Yokoi, Takashi Oishi, Tomoki Kimura, Osamu Nishiyama, Keisuke Kato, Roland M. Du Bois
    Abstract:

    Summary Study objectives Surgical lung biopsy (SLB) plays an important role in the diagnosis of Interstitial Pneumonia, however, the occurrence of acute respiratory failure following SLB remains largely unreported. We evaluated the incidence, clinical features, therapy and prognosis of acute exacerbation of Interstitial Pneumonia following SLB. Design Retrospective study of consecutive patients who underwent SLB to establish a diagnosis of diffuse lung disease between May 1989 and April 2000. Patients with an acute exacerbation following lung biopsy were studied, and the HRCT images of the chest before and after surgery were reviewed. Measurements and results Among the 236 consecutive patients with Interstitial Pneumonia who underwent a surgical lung biopsy, five (2.1%) (IPF, 3; NSIP, 1; COP, 1) developed acute exacerbation of the diffuse lung disease in the course of 1–18 days after SLB. The extent of parenchymal involvement on HRCT before surgery was not significantly different between operated and contralateral nonoperated lung. Significantly increased regions of parenchymal involvement on HRCT were seen postoperatively compared with the preoperative CT in both the operated (20.7±12.5% versus 38.2±10.8%, P = 0.0431 ) and nonoperated lung (22.7±13.8% versus 70.5±24.4%, P = 0.0431 ), but the extent of the parenchymal involvement was significantly greater on the nonoperated side ( P = 0.0251 ). Two of the 3 IPF patients died from the acute exacerbation. Conclusions It is important to be aware of the possibility of acute exacerbation of Interstitial Pneumonia following SLB even after an apparently uneventful immediate postoperative course. The asymmetric image findings suggest that intraoperative respiratory management is a possible etiologic factor.

  • Usual Interstitial Pneumonia and Chronic Idiopathic Interstitial Pneumonia: Analysis of CT Appearance in 92 Patients
    Radiology, 2006
    Co-Authors: Hiromitsu Sumikawa, Takeshi Johkoh, Kiminori Fujimoto, Hiroyuki Taniguchi, Yasuhiro Kondoh, Kazuya Ichikado, Ukihide Tateishi, Tetsuo Hiramatsu, Atsuo Inoue, Javzandulam Natsag
    Abstract:

    Purpose: To retrospectively analyze computed tomographic (CT) findings of chronic idiopathic Interstitial Pneumonia (IIP) and to determine which findings are most helpful for distinguishing IIP from usual Interstitial Pneumonia (UIP) with univariate and multivariate analyses. Materials and Methods: Institutional review board approval and informed consent were not required for this retrospective review of patient records and images. Two observers working independently and without knowledge of the diagnosis evaluated the extent and distribution of various thin-section CT findings (ground-glass opacity, consolidation, reticulation, and honeycombing) in 92 patients (51 men, 41 women; mean age, 56 years; age range, 29–81 years) with a histologic diagnosis of UIP (n = 20), cellular nonspecific Interstitial Pneumonia (NSIP) (n = 16), fibrotic NSIP (n = 16), respiratory bronchiolitis–associated Interstitial lung disease (RB-ILD) (n = 11), desquamative Interstitial Pneumonia (DIP) (n = 15), or lymphoid interstitia...

Kevin K Brown - One of the best experts on this subject based on the ideXlab platform.

  • high resolution ct scan findings in familial Interstitial Pneumonia do not conform to those of idiopathic Interstitial Pneumonia
    Chest, 2012
    Co-Authors: Mark P Steele, Kevin K Brown, Marvin I Schwarz, James E Loyd, Janet Talbert, David A Schwartz, David A. Lynch
    Abstract:

    Background The aim of this study was to describe the high-resolution CT (HRCT) scan features that characterize familial Interstitial Pneumonia (FIP). Methods FIP was defined by the presence of two or more cases of probable or definite idiopathic Interstitial Pneumonia (IIP) in individuals related within three degrees. The cases were collected consecutively from three centers. We identified 371 individuals with potential FIP from 289 families, including 340 individuals who had HRCT scans. Two chest radiologists independently reviewed the HRCT scans, scoring the extent and distribution of HRCT scan findings, and assessed the overall radiologic diagnosis. Results HRCT scan abnormalities suggestive of IIP were present in 85% (289 of 340 subjects). The most frequent findings were reticular pattern (n = 238, 82%) and ground-glass opacity (GGO) associated with reticular abnormality (n = 231, 80%). Other changes included GGO in 116 (40%), honeycombing in 92 (32%), and micronodules in 65 (22%). In the 289 cases with evidence of IIP, the findings were diffusely distributed in the craniocaudal plane in 186 (64%), and the lower lung zones were predominantly involved in 89 (31%). In the axial plane, 194 (67%) had a subpleural distribution; 88 (30%) were diffuse. The imaging pattern was classified as definite or probable usual Interstitial Pneumonia (UIP) in only 62 subjects (22%) and definite or probable nonspecific Interstitial Pneumonia (NSIP) in 35 subjects (12%). In 160 subjects (55%), the imaging findings did not conform to previously described UIP or NSIP patterns. Conclusions Reticulation and a mixed GGO/reticular pattern are the most common HRCT scan findings in FIP. The parenchymal abnormalities are most often diffuse in the craniocaudal dimension and have a predominantly peripheral distribution in the axial dimension. Although a radiologic UIP pattern is not uncommon, most cases do not conform to typical UIP or NSIP patterns.

  • gene expression profiling of familial and sporadic Interstitial Pneumonia
    American Journal of Respiratory and Critical Care Medicine, 2007
    Co-Authors: Ivana V Yang, Lauranell H Burch, Mark P Steele, Jordan D Savov, John W Hollingsworth, Erin Mcelvaniatekippe, Katherine G Berman, Marcy C Speer, Thomas A Sporn, Kevin K Brown
    Abstract:

    Rationale: Idiopathic Interstitial Pneumonia (IIP) and its familial variants are progressive and largely untreatable disorders with poorly understood molecular mechanisms. Both the genetics and the histologic type of IIP play a role in the etiology and pathogenesis of Interstitial lung disease, but transcriptional signatures of these subtypes are unknown. Objectives: To evaluate gene expression in the lung tissue of patients with usual Interstitial Pneumonia or nonspecific Interstitial Pneumonia that was either familial or nonfamilial in origin, and to compare it with gene expression in normal lung parenchyma. Methods: We profiled RNA from the lungs of 16 patients with sporadic IIP, 10 with familial IIP, and 9 normal control subjects on a whole human genome oligonucleotide microarray. Results: Significant transcriptional differences exist in familial and sporadic IIPs. The genes distinguishing the genetic subtypes belong to the same functional categories as transcripts that distinguish IIP from normal samples. Relevant categories include chemokines and growth factors and their receptors, complement components, genes associated with cell proliferation and death, and genes in the Wnt pathway. The role of the chemokine CXCL12 in disease pathogenesis was confirmed in the murine bleomycin model of lung injury, with C57BL/6CXCR4+/− mice demonstrating significantly less collagen deposition than C57BL/6CXCR4+/+ mice. Whereas substantial differences exist between familial and sporadic IIPs, we identified only minor gene expression changes between usual Interstitial Pneumonia and nonspecific Interstitial Pneumonia. Conclusions: Taken together, our findings indicate that differences in gene expression profiles between familial and sporadic IIPs may provide clues to the etiology and pathogenesis of IIP.

  • lymphoid Interstitial Pneumonia clinical features associations and prognosis
    European Respiratory Journal, 2006
    Co-Authors: Michael B Fessler, Carlyne D Cool, Marvin I Schwarz, Kevin K Brown
    Abstract:

    Lymphoid Interstitial Pneumonia (LIP) is rare and its clinical course incompletely described. The aim of this study was to examine the clinical features, associations and prognosis of surgical lung biopsy-proven LIP. The study group consisted of 15 subjects encountered over a 14-yr period. The majority of subjects were females (n = 11) and the mean age was 47 yrs (range 17–78 yrs). Underlying systemic immune disorders were frequent, including Sjogren's syndrome (n = 8), rheumatoid arthritis, systemic lupus erythematosus, polymyositis, common variable immunodeficiency and dysproteinaemia. Only three patients were classified as “idiopathic”. Presenting symptoms were dominated by dyspnoea and cough. Restrictive physiology, reduced diffusion capacity (62.5±18.4% predicted) and bronchoalveolar lavage lymphocytosis (30.5±29.1% pred) were noted. Thirteen patients received corticosteroid therapy. Of the nine whose response could be assessed, four showed clinical improvement and four were stable. Overall, median survival was 11.5 yrs. Of the seven patients who died, respiratory problems were the primary cause of death in three. Conversion to lymphoma was not identified. In conclusion, histopathological lymphoid Interstitial Pneumonia is commonly associated with immune system dysregulation, with idiopathic lymphoid Interstitial Pneumonia being extremely rare. Clinical stability or improvement with corticosteroids can be expected; however, survival remains impaired.

  • high resolution computed tomography features of nonspecific Interstitial Pneumonia and usual Interstitial Pneumonia
    Journal of Computer Assisted Tomography, 2005
    Co-Authors: Tracy L Elliot, David A. Lynch, John D Newell, Carlyne D Cool, Rubin M Tuder, Katerina Markopoulou, Robert Veve, Kevin K Brown
    Abstract:

    Objective: To assess the accuracy of high-resolution computed tomography (HRCT) in the diagnosis of nonspecific Interstitial Pneumonia (NSIP). We hypothesized that the computed tomography (CT) features of NSIP could be distinguished from those of usual Interstitial Pneumonia (UIP). Methods: The HRCT images of 47 patients with surgical lung biopsy-proven NSIP (n = 25) and UIP (n = 22) were independently reviewed by 2 thoracic radiologists. Predominant imaging patterns, most likely diagnosis, and diagnostic level of confidence were recorded. A confident HRCT diagnosis of NSIP was based on the presence of spatially uniform, bilateral, basal-predominant ground-glass and/or reticular opacities with little if any honeycombing, whereas UIP was confidently diagnosed if a spatially inhomogeneous, bilateral, peripheral, basal-predominant pattern of reticular opacities and honeycombing with little if any ground-glass attenuation was identified. Results: A predominant pattern of ground-glass and/or reticular opacity with minimal to no honeycombing was demonstrated in 48 (96%) of 50 readings in patients with NSIP. Conversely, the presence of honeycombing as a predominant feature had a predictive value of 90% for UIP (P < 0.001). Usual Interstitial Pneumonia was more likely than NSIP to be subpleural and patchy (P < 0.001). A confident CT diagnosis of NSIP and UIP was correct in 73% and 88% of cases, respectively. The correctness of a CT diagnosis made at intermediate or high confidence was 68% and 88%, respectively. The kappa value for distinction of NSIP from UIP was 0.72. Conclusion: In contrast to previous reports, NSIP can be separated from UIP in most cases. The presence of honeycombing as a predominant imaging finding is highly specific for UIP and can be used to differentiate it from NSIP, particularly when the distribution is patchy and subpleural predominant. The presence of predominant ground-glass and reticular opacity is highly characteristic of NSIP, but there is a subset of patients with UIP who have this pattern and may require biopsy for differentiation from NSIP.

Hiroyuki Taniguchi - One of the best experts on this subject based on the ideXlab platform.

  • pathologically proved nonspecific Interstitial Pneumonia ct pattern analysis as compared with usual Interstitial Pneumonia ct pattern
    Radiology, 2014
    Co-Authors: Hiromitsu Sumikawa, Thomas V Colby, Takeshi Johkoh, Kiminori Fujimoto, Hiroaki Arakawa, Junya Fukuoka, Hiroyuki Taniguchi, Yasuhiro Kondoh, Kensuke Kataoka, Takashi Ogura
    Abstract:

    Although patients with pathologically proved idiopathic pulmonary fibrosis/usual Interstitial Pneumonia showed variable CT patterns, those with pathologically proved nonspecific Interstitial Pneumonia showed less variable CT patterns.

  • acute Interstitial Pneumonia
    American Journal of Respiratory and Critical Care Medicine, 2012
    Co-Authors: Kazuya Ichikado, Takeshi Johkoh, Hiroyuki Taniguchi, Yasuhiro Kondoh, Moritaka Suga, Nestor L Muller, Masanori Akira, Naoki Mihara, Hironobu Nakamura, Mutsumasa Takahashi
    Abstract:

    This study compared high-resolution computed tomography (CT) findings between 10 survivors and 21 nonsurvivors of acute Interstitial Pneumonia and evaluated whether the CT findings were predictive of patients' response to treatment. The survivor and nonsurvivor groups with pathologically or clinically diagnosed acute Interstitial Pneumonia were similar in age, sex, disease duration, and lung injury score. Retrospective, subjective evaluations of the CT scans were conducted by two independent observers without knowledge of patient outcomes. CT findings were graded on a one to six scale corresponding to consecutive pathologic phases as follows: areas of (1) normal attenuation, (2) ground-glass attenuation, (3) consolidation, (4) ground-glass attenuation associated with traction bronchiolectasis or bronchiectasis, (5) consolidation associated with traction bronchiolectasis or bronchiectasis, and (6) honeycombing. An overall score was obtained by quantifying the extent of each abnormality in three lung zones ...

  • usual Interstitial Pneumonia and chronic idiopathic Interstitial Pneumonia analysis of ct appearance in 92 patients
    Radiology, 2006
    Co-Authors: Hiromitsu Sumikawa, Takeshi Johkoh, Kiminori Fujimoto, Hiroyuki Taniguchi, Yasuhiro Kondoh, Kazuya Ichikado, Ukihide Tateishi, Tetsuo Hiramatsu, Atsuo Inoue, Javzandulam Natsag
    Abstract:

    PURPOSE: To retrospectively analyze computed tomographic (CT) findings of chronic idiopathic Interstitial Pneumonia (IIP) and to determine which findings are most helpful for distinguishing IIP from usual Interstitial Pneumonia (UIP) with univariate and multivariate analyses. MATERIALS AND METHODS: Institutional review board approval and informed consent were not required for this retrospective review of patient records and images. Two observers working independently and without knowledge of the diagnosis evaluated the extent and distribution of various thin-section CT findings (ground-glass opacity, consolidation, reticulation, and honeycombing) in 92 patients (51 men, 41 women; mean age, 56 years; age range, 29-81 years) with a histologic diagnosis of UIP (n = 20), cellular nonspecific Interstitial Pneumonia (NSIP) (n = 16), fibrotic NSIP (n = 16), respiratory bronchiolitis-associated Interstitial lung disease (RB-ILD) (n = 11), desquamative Interstitial Pneumonia (DIP) (n = 15), or lymphoid Interstitial Pneumonia (LIP) (n = 14). Observers used univariate and multivariate statistical analyses to compare their findings with the extent and distribution of UIP. RESULTS: Observers made the correct diagnosis in 145 (79%) of 184 readings. Multivariate logistic regression analysis showed that the independent findings that distinguished UIP from cellular NSIP were the extent of honeycombing and the most proximal bronchus with traction bronchiectasis (odds ratio, 5.16 and 0.37, respectively); the finding that distinguished UIP from fibrotic NSIP was the extent of honeycombing (odds ratio, 2.10). CT features that distinguished UIP from RB-ILD and DIP included extent of ground-glass opacity (odds ratio, 0.76), thickening of bronchovascular bundles (odds ratio, 1.58), the most proximal bronchus with traction bronchiectasis (odds ratio, 0.22), and the number of segments with traction bronchiectasis (odds ratio, 3.64). CONCLUSION: UIP has a characteristic appearance that usually facilitates distinction from other types of chronic IIPs at thin-section CT. The most useful finding when differentiating UIP from NSIP was the extent of honeycombing.

  • acute exacerbation of Interstitial Pneumonia following surgical lung biopsy
    Respiratory Medicine, 2006
    Co-Authors: Yasuhiro Kondoh, Masanori Kitaichi, Takeshi Johkoh, Hiroyuki Taniguchi, Toyoharu Yokoi, Takashi Oishi, Tomoki Kimura, Osamu Nishiyama, Keisuke Kato, Roland M. Du Bois
    Abstract:

    Summary Study objectives Surgical lung biopsy (SLB) plays an important role in the diagnosis of Interstitial Pneumonia, however, the occurrence of acute respiratory failure following SLB remains largely unreported. We evaluated the incidence, clinical features, therapy and prognosis of acute exacerbation of Interstitial Pneumonia following SLB. Design Retrospective study of consecutive patients who underwent SLB to establish a diagnosis of diffuse lung disease between May 1989 and April 2000. Patients with an acute exacerbation following lung biopsy were studied, and the HRCT images of the chest before and after surgery were reviewed. Measurements and results Among the 236 consecutive patients with Interstitial Pneumonia who underwent a surgical lung biopsy, five (2.1%) (IPF, 3; NSIP, 1; COP, 1) developed acute exacerbation of the diffuse lung disease in the course of 1–18 days after SLB. The extent of parenchymal involvement on HRCT before surgery was not significantly different between operated and contralateral nonoperated lung. Significantly increased regions of parenchymal involvement on HRCT were seen postoperatively compared with the preoperative CT in both the operated (20.7±12.5% versus 38.2±10.8%, P = 0.0431 ) and nonoperated lung (22.7±13.8% versus 70.5±24.4%, P = 0.0431 ), but the extent of the parenchymal involvement was significantly greater on the nonoperated side ( P = 0.0251 ). Two of the 3 IPF patients died from the acute exacerbation. Conclusions It is important to be aware of the possibility of acute exacerbation of Interstitial Pneumonia following SLB even after an apparently uneventful immediate postoperative course. The asymmetric image findings suggest that intraoperative respiratory management is a possible etiologic factor.

  • Usual Interstitial Pneumonia and Chronic Idiopathic Interstitial Pneumonia: Analysis of CT Appearance in 92 Patients
    Radiology, 2006
    Co-Authors: Hiromitsu Sumikawa, Takeshi Johkoh, Kiminori Fujimoto, Hiroyuki Taniguchi, Yasuhiro Kondoh, Kazuya Ichikado, Ukihide Tateishi, Tetsuo Hiramatsu, Atsuo Inoue, Javzandulam Natsag
    Abstract:

    Purpose: To retrospectively analyze computed tomographic (CT) findings of chronic idiopathic Interstitial Pneumonia (IIP) and to determine which findings are most helpful for distinguishing IIP from usual Interstitial Pneumonia (UIP) with univariate and multivariate analyses. Materials and Methods: Institutional review board approval and informed consent were not required for this retrospective review of patient records and images. Two observers working independently and without knowledge of the diagnosis evaluated the extent and distribution of various thin-section CT findings (ground-glass opacity, consolidation, reticulation, and honeycombing) in 92 patients (51 men, 41 women; mean age, 56 years; age range, 29–81 years) with a histologic diagnosis of UIP (n = 20), cellular nonspecific Interstitial Pneumonia (NSIP) (n = 16), fibrotic NSIP (n = 16), respiratory bronchiolitis–associated Interstitial lung disease (RB-ILD) (n = 11), desquamative Interstitial Pneumonia (DIP) (n = 15), or lymphoid interstitia...

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