Clinically occult interstitial fibrosis in smokers: classification and significance of a surprisingly common finding in lobectomy specimens

Katzenstein, Anna-Luise A.; Mukhopadhyay, Sanjay; Zanardi, C; Dexter, Elizabeth U.

doi:10.1016/j.humpath.2009.09.003

Cited by 208 publications

(192 citation statements)

References 11 publications

Supporting

Mentioning

175

Contrasting

Unclassified

Order By: Relevance

“…Finally, there is a more recently described entity of smokingrelated interstitial fibrosis [67]. This is characterized by varying degrees of alveolar septal widening by collagen deposition along with emphysema and respiratory bronchiolitis.…”

Section: Cigarette Smoking and Ildmentioning

confidence: 99%

Expanding the Spectrum of Particle-and Fiber-Associated Interstitial Lung Diseases

Ghio¹

2014

Tur Toraks Der

View full text Add to dashboard Cite

While interstitial lung disease (ILD) is common, less than five percent of diagnoses appear to be related to occupational and environmental exposures to particles and fibers; these injuries are most frequently recognized as pneumoconioses and hypersensitivity pneumonitides. As a result of this small contribution to recognized ILD, the association of particles and fibers with this group of diseases is frequently deemed of little consequence. However, it has been proposed that some portion of ILD without a recognized cause (i.e. idiopathic disease) can also be related to exposures to particles and fibers. Many of these diagnoses are determined without benefit of microscopic examination of lung tissue. Even when tissue is available, the conventional examination for the presence of particles and fibers is used. This approach employing optical microscopy is insensitive and leads to misdiagnosis. A review of previous investigation demonstrates associations of idiopathic pulmonary fibrosis, desquamative interstitial pneumonia, pulmonary alveolar proteinosis, sarcoidosis, and eosinophilic granuloma with particle and fiber exposures. It is recommended that scanning electron microscopy in combination with the use of electron dispersive X-ray analysis be employed whenever the question of a possible relationship between ILD and particle and fiber exposure arises.

show abstract

Section: Cigarette Smoking and Ildmentioning

confidence: 99%

Expanding the Spectrum of Particle-and Fiber-Associated Interstitial Lung Diseases

Ghio¹

2014

Tur Toraks Der

View full text Add to dashboard Cite

show abstract

“…6 It is characterized by uniform thickening of alveolar septa by collagen deposition with minimal associated inflammation (Figure 1). The process is accentuated in subpleural parenchyma where it is usually associated with emphysema, but affects deeper portions of parenchyma as well, especially in centrilobular areas.…”

Section: Smoking-related Interstitial Fibrosismentioning

confidence: 99%

“…7 In a recent detailed histologic analysis of lobectomy specimens from smokers, we identified SRIF in 45% (9/20 cases). 6 The mean age was 65 with a range from 52 to 81. Half were current and half were ex-smokers with mean pack years smoked of 39 and 38, respectively.…”

Section: Smoking-related Interstitial Fibrosismentioning

confidence: 99%

“…Examples include scarred sarcoidosis, chronic hypersensitivity pneumonia, scarred Langerhans cell histiocytosis, and the recently described smoking-related interstitial fibrosis (SRIF). 6 This review will present the pathologic features of SRIF with emphasis on its distinction from other types of fibrosing interstitial lung diseases, especially UIP and NSIP. Additional topics include an update on pathogenesis and therapy of UIP, and the use of transbronchial biopsy (TBB) in UIP.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Smoking-related interstitial fibrosis (SRIF), pathogenesis and treatment of usual interstitial pneumonia (UIP), and transbronchial biopsy in UIP

Katzenstein

2012

Modern Pathology

View full text Add to dashboard Cite

This review focuses on three selected topics of current interest that are related to chronic fibrosing lung disorders and are important for pathologists. First, the clinical and pathologic features of smoking-related interstitial fibrosis (SRIF) are highlighted. SRIF is a common finding in smokers that has striking histologic changes but only mild associated clinical manifestations. It is characterized by marked alveolar septal fibrosis composed of a distinct form of hyalinized collagen deposition. The process is present mainly in subpleural and centrilobular parenchyma and is associated with emphysema and respiratory bronchiolitis. Second, important aspects of the pathogenesis and treatment of usual interstitial pneumonia (UIP) are reviewed. The current theory proposes that UIP is caused by tiny foci of acute lung injury (manifest pathologically by fibroblast foci) that occur and recur in the interstitium over many years. Inflammation may be present as a secondary phenomenon, but is not the primary cause, and therefore anti-inflammatory agents have little effect. The recurrent injury leads to permanent fibrosis, through a process that is considered to represent a form of abnormal wound healing. Multiple therapies have been attempted that are aimed largely at interrupting the fibrosing process, but none have been successful. The cause of the injury is unknown, but a role for aspiration due to gastroesophageal reflux is a popular current theory, and there is some evidence that anti-reflux therapy may be beneficial. Genetic predisposition has been implicated in the etiology of familial cases, and there is evidence that telomere shortening may be important in sporadic cases. Third, the use of transbronchial biopsy (TBB) in diagnosing UIP is reviewed. TBB can provide a surprising amount of information and is especially useful in certain situations, such as elderly or very sick patients in whom surgical lung biopsy carries increased morbidity and mortality.

show abstract

“…Among many other issues, the task force will have to address the still ongoing debate of usual interstitial pneumonia versus nonspecific pneumonia and their frequently overlapping features; the recently individualised syndrome of combined pulmonary fibrosis and emphysema [2]; and new histopathological patterns that might correspond to clinically relevant entities (e.g. acute fibrinous and organising pneumonia, smoking-related interstitial fibrosis [3], etc.) [4]; and will question the adequacy of maintaining, in the group of idiopathic interstitial pneumonias, entities that are mostly due to environmental exposure or tobacco smoking and therefore not idiopathic (e.g.…”

Section: Current Challenges In Ipfmentioning

confidence: 99%

Interstitial lung disease: new challenges and evolving phenotypes

Cottin¹

2010

Eur Respir Rev

View full text Add to dashboard Cite

Clinically occult interstitial fibrosis in smokers: classification and significance of a surprisingly common finding in lobectomy specimens

Cited by 208 publications

References 11 publications

Expanding the Spectrum of Particle-and Fiber-Associated Interstitial Lung Diseases

Expanding the Spectrum of Particle-and Fiber-Associated Interstitial Lung Diseases

Smoking-related interstitial fibrosis (SRIF), pathogenesis and treatment of usual interstitial pneumonia (UIP), and transbronchial biopsy in UIP

Interstitial lung disease: new challenges and evolving phenotypes

Contact Info

Product

Resources

About