Changes in HRCT findings in patients with respiratory bronchiolitis-associated interstitial lung disease after smoking cessation

Nakanishi, Masayoshi; Demura, Yoshiki; Mizuno, Satoko; Ameshima, Shingo; Chiba, Yasutaka; Miyamori, Isamu; Itoh, Harumi; Kitaichi, Masanori; Ishizaki, T

doi:10.1183/09031936.00015506

Cited by 62 publications

(27 citation statements)

References 30 publications

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“…Desquamative interstitial pneumonia is a less common entity than respiratory bronchiolitis interstitial lung disease. Previous studies (27,28) have suggested that the CT findings of respiratory bronchiolitis interstitial lung disease are at least partially reversible, which would account for the fact that GGO improved at follow-up in 41% (13 of 32) of participants in our study.…”

Section: Discussionsupporting

confidence: 51%

Interstitial Lung Abnormalities in a CT Lung Cancer Screening Population: Prevalence and Progression Rate

Jin¹,

Lynch²,

Chawla³

et al. 2013

Radiology

261

237

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Radiology: Volume 268: Number 2-August 2013 n radiology.rsna.org 563 Purpose:To determine the prevalence of interstitial lung abnormalities (ILAs) at initial computed tomography (CT) examination and the rate of progression of ILAs on 2-year follow-up CT images in a National Lung Screening Trial population studied at a single site. Materials and Methods:The study was approved by the institutional review board and informed consent was obtained from all participants. Image review for this study was HIPAA compliant. We reviewed the CT images of 884 cigarette smokers who underwent low-dose CT at a single site in the National Lung Screening Trial. CT findings were categorized as having no evidence of ILA, equivocal for ILA, or ILA. We categorized the type of ILA as nonfibrotic (ground-glass opacity, consolidation, mosaic attenuation), or fibrotic (ground glass with reticular pattern, reticular pattern, honeycombing). We evaluated the temporal change of the CT findings (no change, improvement, or progression) of ILA at 2-year follow-up. A x 2 with Fisher exact test or unpaired t test was used to determine whether smoking parameters were associated with progression of ILA at 2-year follow-up CT. Results:The prevalence of ILA was 9.7% (86 of 884 participants; 95% confidence interval: 7.9%, 11.9%), with a further 11.5% (102 of 884 participants) who had findings equivocal for ILA. The pattern was fibrotic in 19 (2.1%), nonfibrotic in 52 (5.9%), and mixed fibrotic and nonfibrotic in 15 (1.7%) of the 86 participants with ILA. The percentage of current smokers (P = .001) and mean number of cigarette pack-years (P = .001) were significantly higher in those with ILA than those without. At 2-year follow-up of those with ILA (n = 79), findings of nonfibrotic ILA improved in 49% of cases and progressed in 11%. Fibrotic ILA improved in 0% and progressed in 37% of cases. Conclusion:ILA is common in cigarette smokers. Nonfibrotic ILA improved in about 50% of cases, and fibrotic ILA progressed in about 37%.q RSNA, 2013 interstitial lung abnormalities in a cT lung cancer screening Population: Prevalence and Progression Rate

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Section: Discussionsupporting

confidence: 51%

Interstitial Lung Abnormalities in a CT Lung Cancer Screening Population: Prevalence and Progression Rate

Jin¹,

Lynch²,

Chawla³

et al. 2013

Radiology

261

237

View full text Add to dashboard Cite

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“…24 Another study found that centrilobular nodules and ground-glass opacifi cation detected on HRCT scan can be improved by smoking cessation. 25 However, the present study demonstrates that smok ing cessation causes a decrease in the number of micronodules, with no signifi cant changes in ground-glass opacifi cation. Hence, the association of micronodules, ground-glass opacifi cation, and emphysema remains controversial.…”

Section: )contrasting

confidence: 55%

Smoking Cessation in COPD Causes a Transient Improvement in Spirometry and Decreases Micronodules on High-Resolution CT Imaging

Dhariwal

Tennant

Hansell

et al. 2014

Chest

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“…BAL findings in RB-ILD patients usually do not differ from those seen in otherwise normal healthy smokers and include an increased total number of cells with a normal cellular differential analysis [[13]] or an increase in the percentage of macrophages [[15]]. These alveolar macrophages contain brownish, golden, or black tobacco pigment inclusions In the absence of these cells, an alternative diagnosis should be considered.…”

Section: Diagnostic Methods and Criteriamentioning

confidence: 99%

“…Additionally, there have been several other reports focused mainly on the differential diagnosis of RB-ILD based on radiological findings [[9]] and their correlation with clinical and physiological findings [[14]], or on follow-up after smoking cessation [[14],[15]].…”

Section: Definitionmentioning

confidence: 99%

Respiratory bronchiolitis-interstitial lung disease

Siemińska

Krzemieniecki

2014

Orphanet J Rare Dis

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Respiratory bronchiolitis-associated interstitial lung disease (RB-ILD) is a rare, mild inflammatory pulmonary disorder that occurs almost exclusively in current or former heavy smokers, usually between the third and sixth decades, most likely with no gender predilection. The onset is usually insidious with exertional dyspnea and persistent cough, which may be non-productive, developing over a course of weeks or months. RB-ILD may also be diagnosed in asymptomatic patients with functional impairment and chest radiograph or high-resolution computed tomography (HRCT) abnormalities. Histologically, RB-ILD is characterized by the accumulation of yellow-brown pigmented macrophages within the lumens of respiratory bronchioles and alveolar ducts, associated with a patchy submucosal and peribronchiolar chronic inflammation. Common findings also include mild bronchiolar and peribronchiolar alveolar fibrosis that expands contiguous alveolar septa and leads to architectural distortion as well as centrilobular emphysema. Chest radiographs in patients with RB-ILD typically show fine reticulonodular interstitial opacities, while on HRCT central and peripheral bronchial wall thickening, centrilobular nodules, and ground-glass opacities associated with upper lobe centrilobular emphysema are most frequently reported. Pulmonary function testing may be normal but usually demonstrates mixed, predominantly obstructive abnormalities, often combined with hyperinflation and usually associated with a mild to moderate reduction in carbon monoxide diffusion capacity (DLco). The course of RB-ILD is heterogeneous. Some patients respond favorably to corticosteroids and/or smoking cessation, but often there is no functional improvement and the disease progresses despite smoking cessation and treatment.

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Changes in HRCT findings in patients with respiratory bronchiolitis-associated interstitial lung disease after smoking cessation

Cited by 62 publications

References 30 publications

Interstitial Lung Abnormalities in a CT Lung Cancer Screening Population: Prevalence and Progression Rate

Interstitial Lung Abnormalities in a CT Lung Cancer Screening Population: Prevalence and Progression Rate

Smoking Cessation in COPD Causes a Transient Improvement in Spirometry and Decreases Micronodules on High-Resolution CT Imaging

Respiratory bronchiolitis-interstitial lung disease

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