Histopathologic Features of Usual Interstitial Pneumonia and Related Patterns: What is Important for Radiologists?

Tabata, Kazuhiro; Fukuoka, Junya

doi:10.1053/j.sult.2013.10.001

Cited by 8 publications

(8 citation statements)

References 45 publications

(33 reference statements)

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“…Our finding that different underlying ILD etiologies did not change the overall negative prognostic effect of UIP could be interpreted as support for the “UIP bucket” hypothesis [9]. This hypothesis suggests that all ILDs exhibiting UIP make up the same disease-one which eventually progresses to end-stage honeycomb lung as a phenotype regardless of the initial ILD diagnosis.…”

Section: Discussionsupporting

confidence: 61%

“…One could consider PPF to be the terminology for other ILDs which closely follow the disease progression and clinical trajectory of IPF [3,4], which is reflected primarily by a decline in FVC, worsening of dyspnea, reduction in exercise capacity, and deterioration in health-related quality of life [5]. IPF is associated mainly with the radiological and histopathological features of usual interstitial pneumonia (UIP) [6], but UIP can also be present in ILDs other than IPF [7][8][9]. According to the established diagnostic criteria, UIP is histopathologically defined as an area of 1) marked fibrosis/ architectural distortion, ± honeycombing in a predominantly subpleural/ paraseptal distribution; 2) patchy involvement of lung parenchyma by fibrosis; 3) fibroblast foci; and 4) the absence of features that suggest an alternative diagnosis [10].…”

Section: Introductionmentioning

confidence: 99%

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Focal Usual Interstitial Pneumonia-like Fibrosis is a Core Prognostic Factor in Progressive Pulmonary Fibrosis

Tsushima,

Okoshi,

Ishijima

et al. 2023

Preprint

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Progressive pulmonary fibrosis (PPF) is a newly recognized clinical phenotype of interstitial lung diseases in the 2022 interstitial pulmonary fibrosis (IPF) guidelines. This category is based entirely on clinical and radiological factors, and the background histopathology is unknown. Our objective was to investigate the histopathological characteristics of PPF and to examine the correlation between usual interstitial pneumonia (UIP) and prognosis in this new disease type. We hypothesized that the presence of UIP like fibrosis predicts patients’ survival in PPF cases.We selected 201 cases fulfilling the clinical criteria of PPF from case archives. Cases diagnosed as IPF by a multidisciplinary team were excluded. Whole slide images were evaluated by three pathologists who were blind to clinical and radiological data. We measured areas of UIP-like fibrosis and calculated what percentage of the total lesion area they occupied.The presence of focal UIP-like fibrosis amounting to 10% or more of the lesion area was seen in 148 (73.6%), 168 (83.6%), and 165 (82.1%) cases for each pathologist respectively. The agreement of the recognition of UIP-like fibrosis in PPF cases was above κ = 0.6 between all pairs. Survival analysis showed that the presence of focal UIP-like fibrosis correlated with worsened survival under all parameters tested (p < 0.001).The presence of UIP-like fibrosis is a core pathological feature of clinical PPF and its presence within diseased areas is associated with poorer prognosis. This study highlights the importance of considering the presence of focal UIP like fibrosis in the evaluation and management of PPF.

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Section: Discussionsupporting

confidence: 61%

Section: Introductionmentioning

confidence: 99%

Focal Usual Interstitial Pneumonia-like Fibrosis is a Core Prognostic Factor in Progressive Pulmonary Fibrosis

Tsushima,

Okoshi,

Ishijima

et al. 2023

Preprint

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“…However, connective tissue disease-associated pulmonary fibrosis and idiopathic pulmonary fibrosis are often difficult to distinguish from one another. 13 Similar situation applies to MPO-ANCA-related pulmonary fibrosis. 14 However, there is a limited number of manuscripts describing the relationships between CPFE and autoimmune diseases including ANCA, thereby making the clear recognition of biological effect difficult, 15 – 17 calling for further research in this field.…”

Section: Discussionmentioning

confidence: 91%

Pathological and radiological correlation in an autopsy case of combined pulmonary fibrosis and emphysema

Karata¹,

Tanaka²,

Egashira³

et al. 2015

COPD

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We report an educational autopsy case of combined pulmonary fibrosis and emphysema. Radiological patterns of the upper lung were considered as mostly emphysema, but pathological observation revealed significant interstitial fibrosis of usual interstitial pneumonia as a major pathology. The patient eventually developed acute exacerbation of background interstitial pneumonia. Careful radiological and pathological correlation of the current case indicates that regions with distal acinar emphysema on computed tomography image may possess histologically marked dense fibrosis of lethal interstitial pneumonia.

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“…On histology slides four samples were examined: three of them showed patchy fibrosis, few fibroblastic foci and partial architectural distortion with alveolar bronchiolization, favouring the diagnosis of probable UIP pattern [1]. The fourth sample was represented by a longitudinal section of a bronchial wall with cartilage ( Figure 2).…”

Section: Case Reportmentioning

confidence: 99%

Pneumomediastinum after transbronchial cryobiopsy

Barisione

Bianchi

Fiocca

et al. 2018

Monaldi Arch Chest Dis

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Pneumomediastinum is defined as the presence of air or gas within the mediastinum and it rarely complicates bronchoscopy. We report, to our best knowledge, the first case of pneumomediastinum following a transbronchial cryobiopsy (TBLC). TBLC is considered a safe procedure as compared with both transbronchial biopsy and surgical lung biopsy. Systematic reviews, metanalysis and a Pubmed research, revealed that in literature no pneumomediastinum has been mentioned after TBLC. We report this case for to make it known to interventional pulmonologists the possibility that a pneumomediastinum can follow a TBLC. In our case the spontaneous resolution in few days did not require any interventions.

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Histopathologic Features of Usual Interstitial Pneumonia and Related Patterns: What is Important for Radiologists?

Cited by 8 publications

References 45 publications

Focal Usual Interstitial Pneumonia-like Fibrosis is a Core Prognostic Factor in Progressive Pulmonary Fibrosis

Focal Usual Interstitial Pneumonia-like Fibrosis is a Core Prognostic Factor in Progressive Pulmonary Fibrosis

Pathological and radiological correlation in an autopsy case of combined pulmonary fibrosis and emphysema

Pneumomediastinum after transbronchial cryobiopsy

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Histopathologic Features of Usual Interstitial Pneumonia and Related Patterns: What is Important for Radiologists?

Cited by 8 publications

References 45 publications

Focal Usual Interstitial Pneumonia-like Fibrosis is a Core Prognostic Factor in Progressive Pulmonary Fibrosis

Focal Usual Interstitial Pneumonia-like Fibrosis is a Core Prognostic Factor in Progressive Pulmonary Fibrosis

Pathological and radiological correlation in an autopsy case of combined pulmonary fibrosis and&nbsp;emphysema

Pneumomediastinum after transbronchial cryobiopsy

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Pathological and radiological correlation in an autopsy case of combined pulmonary fibrosis and emphysema