Document Detail


Role of surgical lung biopsy in separating chronic hypersensitivity pneumonia from usual interstitial pneumonia/idiopathic pulmonary fibrosis: analysis of 31 biopsies from 15 patients.
MedLine Citation:
PMID:  18339775     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Lung biopsy has been proposed as a criterion for diagnosis of chronic hypersensitivity pneumonia (HP), especially in patients without proven antigen exposure. Histologic findings in some suspected HP patients overlap with usual interstitial pneumonia (UIP) and nonspecific interstitial pneumonia (NSIP). We reviewed our experience to determine the specificity of histologic findings in surgical lung biopsies from patients with clinical diagnoses of HP. METHODS: Surgical lung biopsies from patients with chronic HP, idiopathic pulmonary fibrosis, and idiopathic NSIP were reviewed retrospectively without knowledge of the clinical diagnosis. Each specimen was assigned a histologic diagnosis, and selected histologic findings were tabulated. Clinical data were abstracted from medical records. RESULTS: Fifteen patients with clinical diagnoses of chronic HP underwent biopsy of one to three lobes. Ten showed features diagnostic of HP in all specimens. Two had discordant findings that included HP in one specimen and UIP or nonspecific changes in others. Biopsies from two showed only UIP, and one showed NSIP. Diagnostic features were present in all samples from 9 of the 11 patients with more than one biopsy site (81.8%). Three patients died of disease, including both patients from whom biopsies showed only UIP. CONCLUSIONS: Most patients with a clinical diagnosis of chronic HP have supportive histologic findings in surgical lung biopsies. A subset of HP patients has findings indistinguishable from UIP. Sampling from more than one lobe may be helpful in separating HP from idiopathic pulmonary fibrosis.
Authors:
Syvain Trahan; Viktor Hanak; Jay H Ryu; Jeffrey L Myers
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Publication Detail:
Type:  Journal Article     Date:  2008-03-13
Journal Detail:
Title:  Chest     Volume:  134     ISSN:  0012-3692     ISO Abbreviation:  Chest     Publication Date:  2008 Jul 
Date Detail:
Created Date:  2008-07-16     Completed Date:  2008-08-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  United States    
Other Details:
Languages:  eng     Pagination:  126-32     Citation Subset:  AIM; IM    
Affiliation:
Department of Pathology and Cytology, Institute of Pneumology and Cardiology, Laval University, Sainte-Foy, QC, Canada.
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MeSH Terms
Descriptor/Qualifier:
Aged
Biopsy
Cohort Studies
Diagnosis, Differential
Female
Humans
Lung / pathology*
Lung Diseases, Interstitial / diagnosis*,  pathology
Male
Middle Aged
Prognosis
Pulmonary Fibrosis / diagnosis*,  pathology
Respiratory Hypersensitivity / diagnosis*,  pathology
Retrospective Studies
Sensitivity and Specificity

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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