Complications in Idiopathic Pulmonary Fibrosis: Focus on Their Clinical and Radiological Features

Abstract

<jats:p>Idiopathic pulmonary fibrosis (IPF) is a fibrotic lung disease with uncertain origins and pathogenesis; it represents the most common interstitial lung disease (ILD), associated with a pathological pattern of usual interstitial pneumonitis (UIP). This disease has a poor prognosis, having the most lethal prognosis among ILDs. In fact, the progressive fibrosis related to IPF could lead to the development of complications, such as acute exacerbation, lung cancer, infections, pneumothorax and pulmonary hypertension. Pneumologists, radiologists and pathologists play a key role in the identification of IPF disease, and in the characterization of its complications—which unfortunately increase disease mortality and reduce overall survival. The early identification of these complications is very important, and requires an integrated approach among specialists, in order to plane the correct treatment. In some cases, the degree of severity of patients having IPF complications may require a personalized approach, based on palliative care services. Therefore, in this paper, we have focused on clinical and radiological features of the complications that occurred in our IPF patients, providing a comprehensive and accurate pictorial essay for clinicians, radiologists and surgeons involved in their management.</jats:p>

Utility of Computed Tomographic Angiography for Pulmonary Hypertension Assessment in a Cohort of West Highland White Terriers With or Without Canine Idiopathic Pulmonary Fibrosis

“…In human medicine, HRCT is commonly used in patients with lower airway disease (17), and in addition to specifying the cause of the disease, HRCT with computed tomographic angiography (CTA) can identify comorbidities with repercussions on prognosis such as PH (18). In humans, diameter of the pulmonary trunk (PT), pulmonary trunk-to-aorta ratio (PT/Ao), and right ventricle-to-left ventricle ratio (RV/LV) are measured alone or in combination to assess the presence of PH (19)(20)(21).…”

Clinical implication of interstitial lung abnormality in elderly patients with early‐stage non‐small cell lung cancer

“…Pretreatment risk stratification is especially emphasized in lung cancer patients with IPF, as the lung is vulnerable to cancer‐related therapies in this group, thus unexpectedly leading to a disastrous event. 29 Although previous studies already demonstrated that pretreatment ILA is a risk factor for pulmonary complication following cancer‐related therapies, 8 our study goes one step further and raises the need to put patients with pretreatment ILA on the same line as IPF and establish different treatment strategies.…”

Characterisation of changes in global genes expression in the lung of ICR mice in response to the inflammation and fibrosis induced by polystyrene nanoplastics inhalation

“…This condition is accompanied by scarring and thickening of the tissue around and between the alveoli in lung tissue. This condition has various symptoms and complications, including shortness of breath, a dry cough, weight loss, nail clubbing, pulmonary hypertension, lung cancer, and pneumothorax [ 37 ]. During fibrosis, pro-fibrotic mediators are secreted from the activated macrophages and neutrophils and promote the accumulation of myofibroblasts that produce extracellular matrix (ECM) [ 38 , 39 ].…”