Distribution of emphysema and fibrosis in idiopathic pulmonary fibrosis with coexisting emphysema

Kinoshita, Yoshiaki; Watanabe, Kentaro; Ishii, Hiroshi; Kushima, Hisako; Fujita, Masaki; Nabeshima, Kazuki

doi:10.1111/his.13831

Cited by 12 publications

(19 citation statements)

References 23 publications

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“…The combination of FIP and emphysema is not uncommon (14). Emphysema is usually accompanied by UIP and they often occur together in the lower lobe (15). Although there was no significant difference in our study in terms of the coexistence of emphysema and UIP, the fact that emphysema was present in 40.7% of all cases is quite important.…”

Section: Discussioncontrasting

confidence: 56%

Validity of Histopathologic Lesions in the Diagnosis of Fibrotic Interstitial Lung Diseases

Ürer¹,

Fener²,

Ünver³

et al. 2021

hamidiyemedj

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Fibrotik interstisyel pnömoni (FİP) akciğer interstisyumun ilerleyici ve dinamik bir hastalık grubudur. Usual interstisyel pnömoni (UİP), sentrilobüler fibrozis (SF), fibrotik non-spesifik interstisyel pnömoni (NSİP) majör paternlerdir. Tipik bir patern olmasa da kistik intralobüler obliteratif fibrozis (KİOF) lobülü tümüyle ortadan kaldıran bir diğer patern olabilir. Çalışmanın amacı FİP patoloji tanısında paternlerin önemini araştırmaktır. Lezyonları UİP sınıflamasına göre değerlendirerek sensitivite ve spesifiteyi belirlemektir. Gereç ve Yöntemler: FİP tanılı olgular tekrar değerlendirilerek incelendi. Fibrozis paterni güncel rehberlere göre UİP, SF, NSİP ve sınıflanmayan olarak gruplandı. Baskın patern ve eğer varsa sekonder patern arandı. Ayrıca KİOF patern olarak değerlendirildi. UİP kesin, olası, belirsiz ve alternatif tanı olarak gruplandı. Lezyonların sensitivite ve spesifite değerleri hesaplandı. Morfolojik patern ile bronşektazi, ossifikasyon, amfizem arasında ilişki araştırıldı.

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Section: Discussioncontrasting

confidence: 56%

Validity of Histopathologic Lesions in the Diagnosis of Fibrotic Interstitial Lung Diseases

Ürer¹,

Fener²,

Ünver³

et al. 2021

hamidiyemedj

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“…The two histological diagnoses more commonly coexist in each lobe. 29 The extent of fibrosis in high-resolution computed tomography (HRCT) has a more significant impact on DLCO than emphysema 30 and pulmonary fibrotic changes may be more important contributors than emphysema for disease progression. 31 Both radiologists and clinicians should bear in mind that recognition and stratification of CPFE using quantitative CT analysis may be used as an important prognostic tool.…”

Section: Radiological Appearancementioning

confidence: 99%

Combined Pulmonary Fibrosis and Emphysema

Bolaki

Αντωνίου

2020

Semin Respir Crit Care Med

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Combined pulmonary fibrosis and emphysema (CPFE) is a clinical entity characterized by the combination of upper lobe emphysema and lower lobe fibrosis, the latter owing to various interstitial lung diseases. These patients have a characteristic lung function profile, with relatively preserved dynamic and static lung volumes, contrasting with a significant reduction of carbon monoxide transfer. The pathogenic mechanisms leading to the coexistence of emphysema with fibrosis remain unclear and different theories have been proposed. CPFE is frequently complicated by pulmonary hypertension, acute exacerbations, and lung cancer leading to poor natural history and prognosis. The syndrome of CPFE represents a distinct pulmonary manifestation in the spectrum of lung diseases associated with connective tissue diseases. Currently, there are no established recommendations regarding the management of patients with CPFE. We provide a review on the existing knowledge of CPFE regarding the epidemiology, pathogenesis, clinical manifestations, radiologic appearance, complications, prognosis, and possible treatment options.

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“…Alveolar airspace enlargement and alveolar destruction, in accordance with emphysema de nition [17],…”

Section: Histo-morphometric Assessment Of Airspace Enlargementsmentioning

confidence: 71%

Multimodality Approach to Characterizing the Distinctive Hallmarks of Lung Fibrosis: A Mouse Model with Bleomycin and Indocyanine Green

Grandi

Ferrini

Ciccimarra

et al. 2021

Preprint

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Background.Idiopathic Pulmonary Fibrosis is a progressive disease with short life expectancy and no disease-modifying pharmacological therapy. The continuous refinement of animal models and the integration of in-vivo imaging techniques is fundamental for the selection of new antifibrotic drugs.Indocyanine Green (ICG), a fluorescent dye, was administered by oropharyngeal aspiration (OA) to mice with Bleomycin (BLM) to map the lung exposure.Methods.Female mice C57bl/6 were treated via OA with BLM+ICG or ICG. Animals were imaged at 7, 14 and 21 days either with the fluorescent system or Micro-CT. At each time point subsets of mice were sampled for ex-vivo assessment. Histological assessment of fibrosis by Ashcroft score, airspace enlargements and mean linear intercept (MLI) were evaluated at 7, 14 and 21 days. Leukocytes and cytokines were measured in bronchoalveolar lavage fluid. Results.Fluorescence imaging revealed a persistent lung signal in both groups until 21 days. In BLM+ICG group, Micro-CT detected a marked increase in hypo- and non-aerated tissues throughout the study. At later time points hyper-inflated tissue was detected. Histology revealed high Ashcroft score throughout the time-course with a prominent increase in airspace size and MLI at day 21. ICG mice had healthy lungs.Conclusions.We showed that ICG can be used as a tracer to map the distribution of BLM in lungs. However, BLM+ICG produced unexpected severe lung changes different from pure BLM model, such as emphysema-like features which progressively worsened. The multimodalities approach warranted characterization of the distinctive features of this new pulmonary fibrosis model and provided fundamentals for in-vivo translation.

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Distribution of emphysema and fibrosis in idiopathic pulmonary fibrosis with coexisting emphysema

Cited by 12 publications

References 23 publications

Validity of Histopathologic Lesions in the Diagnosis of Fibrotic Interstitial Lung Diseases

Validity of Histopathologic Lesions in the Diagnosis of Fibrotic Interstitial Lung Diseases

Combined Pulmonary Fibrosis and Emphysema

Multimodality Approach to Characterizing the Distinctive Hallmarks of Lung Fibrosis: A Mouse Model with Bleomycin and Indocyanine Green

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