LAM is another small airway disease: lessons from microCT

Bourdin, Arnaud; Gamez, Anne Sophie; Vachier, Isabelle; Crestani, Bruno

doi:10.1183/13993003.02162-2020

Cited by 3 publications

(2 citation statements)

References 5 publications

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“…17 The introduction of microcomputed tomography (microCT) has enabled three-dimensional (3D) morphologic assessments of lung tissues that are very difficult to achieve with conventional histologic analysis. 12,13,18,19 In addition, microCT of frozen air-inflated tissue enables quantitative assessment without shrinkage and physical cutting of tissues. 20 Mai et al 16 combined CT, microCT, and histologic assessment, and found that fibrosis and honeycomb cyst formation in IPF extend from the peripheral to the central region of the pulmonary lobules.…”

mentioning

confidence: 99%

Pathology of Idiopathic Pulmonary Fibrosis Assessed by a Combination of Microcomputed Tomography, Histology, and Immunohistochemistry

Tanabe

McDonough

Vasilescu

et al. 2020

The American Journal of Pathology

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mentioning

confidence: 99%

Pathology of Idiopathic Pulmonary Fibrosis Assessed by a Combination of Microcomputed Tomography, Histology, and Immunohistochemistry

Tanabe

McDonough

Vasilescu

et al. 2020

The American Journal of Pathology

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“…Given the above evidence, it is clear that microCT can serve as a complementary, and in the future perhaps even an indispensable tool for routine pathology ( 32 ). Although significant technical advances have been made, there is still some work to be done.…”

Section: Discussionmentioning

confidence: 99%

From Macroscopy to Ultrastructure: An Integrative Approach to Pulmonary Pathology

et al. 2022

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Pathology and radiology are complimentary tools, and their joint application is often crucial in obtaining an accurate diagnosis in non-neoplastic pulmonary diseases. However, both come with significant limitations of their own: Computed Tomography (CT) can only visualize larger structures due to its inherent–relatively–poor resolution, while (histo) pathology is often limited due to small sample size and sampling error and only allows for a 2D investigation. An innovative approach of inflating whole lung specimens and subjecting these subsequently to CT and whole lung microCT allows for an accurate matching of CT-imaging and histopathology data of exactly the same areas. Systematic application of this approach allows for a more targeted assessment of localized disease extent and more specifically can be used to investigate early mechanisms of lung diseases on a morphological and molecular level. Therefore, this technique is suitable to selectively investigate changes in the large and small airways, as well as the pulmonary arteries, veins and capillaries in relation to the disease extent in the same lung specimen. In this perspective we provide an overview of the different strategies that are currently being used, as well as how this growing field could further evolve.

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Health Care Situation in the Treatment of Uncontrolled GINA Step 4/5 Patients in Germany

Timmermann¹,

Milger²,

Virchow³

et al. 2023

JAA

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Purpose It has been estimated that, in 2019, 54,000 patients in Germany had uncontrolled GINA step 4/5 asthma. In the current study we analyzed which health care providers were involved in the management of these patients and their role in disease phenotyping. Patients and Methods The year 2019 was retrospectively analyzed using the IQVIA TM LRx, a longitudinal anonymized prescription database, and the electronic, anonymized medical records database, the IQVIA Disease Analyzer. Results Of 54,000 uncontrolled GINA step 4/5 asthma patients in Germany, 52% had consulted both general practitioners (GPs) and pulmonologists, and 48% were seen exclusively by a GP. Of these 54,000 patients, 45% were being prescribed and were thus overusing short-acting β2-agonists (SABAs) and oral corticosteroids (OCS) for ≥2 years, 26% for ≥3 years, and 16% for ≥4 years. In most regions, pulmonologists saw one of their uncontrolled GINA step 4/5 asthma patients per week. Laboratory tests from consultations with a GP were available for only 10% of patients referred to a pulmonologist. In 50% of uncontrolled asthma patients treated according to GINA step 4/5, these were initiated by the pulmonologist, and 34% received laboratory testing within the first year (in GINA step 4/5 asthma, the numbers are 20% and 18%, respectively). Conclusion Fifty percent of uncontrolled asthma patients treated according to GINA step 4/5 were regularly seen by pulmonologists, who performed most of the phenotyping confirming their importance in the management of severe, uncontrolled asthma in Germany. To understand treatment pathways for these patients, further studies are needed.

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LAM is another small airway disease: lessons from microCT

Cited by 3 publications

References 5 publications

Pathology of Idiopathic Pulmonary Fibrosis Assessed by a Combination of Microcomputed Tomography, Histology, and Immunohistochemistry

Pathology of Idiopathic Pulmonary Fibrosis Assessed by a Combination of Microcomputed Tomography, Histology, and Immunohistochemistry

From Macroscopy to Ultrastructure: An Integrative Approach to Pulmonary Pathology

Health Care Situation in the Treatment of Uncontrolled GINA Step 4/5 Patients in Germany

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