| Pathologic quantification of connective tissue disease-associated versus idiopathic usual interstitial pneumonia. | |
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MedLine Citation:
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PMID: 23020731 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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Context.-Usual interstitial pneumonia (UIP) is a common chronic interstitial pneumonitis. It can occur idiopathically (I-UIP) or in the setting of systemic connective tissue disease (CTD-UIP). Some studies suggest that CTD-UIP has a better prognosis than I-UIP. The histologic differences between CTD-UIP and I-UIP are not clearly defined. Objective.-The purpose of this study was to evaluate histologic criteria that may differentiate CTD-UIP from I-UIP, including fibroblastic foci (FFs), lymphoid aggregates (LAs), and the presence of nonspecific interstitial pneumonia pattern. Design.-Thirty-five patients with histologic diagnoses of UIP were identified (27 biopsies [77%]; 8 explants [23%]). Biopsy slides were scanned and analyzed quantitatively for FF size, FF area, LA size, and LA area. Biopsy and explant slides were examined qualitatively for the presence of a nonspecific interstitial pneumonia pattern in areas away from UIP fibrosis. Results.-Of 27 biopsies, the number and size of FFs in CTD-UIP were smaller than they were in I-UIP. The number and size of LAs were larger in patients with rheumatoid arthritis than they were in patients with I-UIP. There was no interobserver variability among 3 pathologists using this quantitative system. Of 35 biopsies and explants, there was a higher prevalence of the nonspecific interstitial pneumonia pattern among patients with CTD-UIP than there was among patients with I-UIP (P = .005). Conclusions.-Patients with CTD-UIP had fewer, smaller FFs than did patients with I-UIP, and patients with rheumatoid arthritis-UIP had more, larger LAs than did patients with I-UIP. Of importance, the coexistence of UIP and the nonspecific interstitial pneumonia patterns was one of the most salient features in distinguishing CTD-UIP from I-UIP because CTD-UIP demonstrated an increased prevalence of multilobar, cellular, nonspecific interstitial pneumonia patterns in areas away from the UIP fibrosis. |
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Authors:
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Nicole A Cipriani; Mary Strek; Imre Noth; Ilyssa O Gordon; Jeff Charbeneau; Jerry A Krishnan; Thomas Krausz; Aliya N Husain |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Archives of pathology & laboratory medicine Volume: 136 ISSN: 1543-2165 ISO Abbreviation: Arch. Pathol. Lab. Med. Publication Date: 2012 Oct |
Date Detail:
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Created Date: 2012-10-01 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7607091 Medline TA: Arch Pathol Lab Med Country: United States |
Other Details:
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Languages: eng Pagination: 1253-8 Citation Subset: AIM; IM |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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