Pulmonary Disease Associated with Pleural “Asbestos” Plaques

Sison, Raymund; Hruban, Ralph H.; Moore, Gary; Kuhlman, Janet E.; Wheeler, Paul S.; Hutchins, Grover M.

doi:10.1378/chest.95.4.831

Cited by 27 publications

(10 citation statements)

References 15 publications

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“…Generally, these abnormalities were not near the pleural plaques. Consistent with previous studies [Sison et al, 1989], 6 of our 35 patients with abnormal lung densities had no pleural plaques. These subjects had similar exposure, medical history, and symptoms to those with pleural plaques.…”

Section: Discussionsupporting

confidence: 92%

High-resolution computed tomography abnormalities in ex-insulators annually exposed to asbestos dust

Soulat¹,

Lauque²,

Esquirol³

et al. 1999

Am. J. Ind. Med.

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Section: Discussionsupporting

confidence: 92%

High-resolution computed tomography abnormalities in ex-insulators annually exposed to asbestos dust

Soulat¹,

Lauque²,

Esquirol³

et al. 1999

Am. J. Ind. Med.

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“…They may also be present in eosinophilic pneumonia, hypersensitivity pneumonitis [170,174], pneumonia distal to obstruction (especially of neoplastic origin), abscesses, aspiration pneumonia [16,175,176], cystic fibrosis [177,178], organising diffuse alveolar damage of any cause, pneumoconiosis [179], or in the vicinity of pleural plaques [180]. Furthermore, microbiological studies on lung tissue may be helpful, including special stains to exclude infection, especially opportunistic infection.…”

Section: Histopathological Diagnosis Of Organising Pneumoniamentioning

confidence: 99%

Cryptogenic organising pneumonia

Jf¹

2006

European Respiratory Journal

477

466

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Organising pneumonia is defined histopathologically by intra-alveolar buds of granulation tissue, consisting of intermixed myofibroblasts and connective tissue. Although nonspecific, this histopathological pattern, together with characteristic clinical and imaging features, defines cryptogenic organising pneumonia when no cause or peculiar underlying context is found. Rapid clinical and imaging improvement is obtained with corticosteroid treatment, but relapses are common after stopping treatment.

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“…106 For example, some foci of OP can be found in more than half of the cases diagnosed with granulomatosis with polyangiitis ( Wegener's), [107][108][109] and may be observed in NSIP, CEP, 79 hypersensitivity pneumonitis, 110,111 chronic pneumonia distal to bronchial obstruction (including especially lung cancer), abscesses, cystic fibrosis, 112 pneumoconiosis, 113 the organizing phase of DAD, 7 or adjacent to pleural plaques. 114 Therefore the pathological diagnosis of OP must be made only in those cases where intraalveolar organization is the predominant pattern, and assessing the significance of OP may be difficult in small biopsy specimen.…”

Section: Differential Pathological Diagnosis Of Organizing Pneumoniamentioning

confidence: 99%

Cryptogenic Organizing Pneumonia

Cottin

Cordier

2012

Semin Respir Crit Care Med

141

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Organizing pneumonia (OP) is a pathological pattern defined by the characteristic presence of buds of granulation tissue within the lumen of distal pulmonary airspaces consisting of fibroblasts and myofibroblasts intermixed with loose connective matrix. This pattern is the hallmark of a clinical pathological entity, namely cryptogenic organizing pneumonia (COP) when no cause or etiologic context is found. The process of intraalveolar organization results from a sequence of alveolar injury, alveolar deposition of fibrin, and colonization of fibrin with proliferating fibroblasts. A tremendous challenge for research is represented by the analysis of features that differentiate the reversible process of OP from that of fibroblastic foci driving irreversible fibrosis in usual interstitial pneumonia because they may determine the different outcomes of COP and idiopathic pulmonary fibrosis (IPF), respectively. Three main imaging patterns of COP have been described: (1) multiple patchy alveolar opacities (typical pattern), (2) solitary focal nodule or mass (focal pattern), and (3) diffuse infiltrative opacities, although several other uncommon patterns have been reported, especially the reversed halo sign (atoll sign). Definitive diagnosis is based on (1) a suggestive clinical radiological presentation, (2) the demonstration of the characteristic pathological pattern at lung histopathology, and (3) exclusion of possible causes. Transbronchial biopsies or a transthoracic biopsy may also contribute to the pathological diagnosis. Rapid clinical and imaging improvement is obtained with corticosteroid therapy. Because of the risk of misdiagnosing alternative conditions that may mimic OP, only typical cases may be managed without histopathological confirmation, and patients should be followed with particular attention paid to any clue of alternate diagnosis, especially in case of incomplete response to treatment. Patients and clinicians must be aware of frequent relapses after stopping corticosteroid treatment.

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Pulmonary Disease Associated with Pleural “Asbestos” Plaques

Cited by 27 publications

References 15 publications

High-resolution computed tomography abnormalities in ex-insulators annually exposed to asbestos dust

High-resolution computed tomography abnormalities in ex-insulators annually exposed to asbestos dust

Cryptogenic organising pneumonia

Cryptogenic Organizing Pneumonia

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