CT-Definable Subtypes of Chronic Obstructive Pulmonary Disease: A Statement of the Fleischner Society

Lynch, David A.; Austin, John; Hogg, James C.; Greniér, Philippe; Kauczor, Hans Ulrich; Bankier, Alexander A.; Barr, R. Graham; Colby, Thomas V.; Galvin, Jeffrey R.; Gevenois, Pierre Alain; Coxson, Harvey O.; Hoffman, Eric A.; Newell, John D.; Pistolesi, Massimo; Silverman, Edwin K.; Crapo, James D.

doi:10.1148/radiol.2015141579

Cited by 488 publications

(450 citation statements)

References 128 publications

Supporting

Mentioning

430

Contrasting

Unclassified

Order By: Relevance

“…The relative contribution of these two processes varies across individuals and emphysematous destruction is further categorized based on its morphology: centrilobular emphysema (CLE), panlobular emphysema (PLE), and paraseptal emphysema (1)(2)(3). These pathologic features underlie various clinical and radiographic manifestations in COPD and, in particular, CLE and PLE have been recognized as distinct pathologic phenotypes (3)(4)(5)(6). Histologic comparisons have shown that emphysematous destruction is more heterogeneous and small airway disease is more severe in CLE than in PLE (4,5,7).…”

Section: Measurements and Main Resultsmentioning

confidence: 99%

“…This imaging technique has been widely used to describe and quantify all of the classic pathologic phenotypes of emphysematous destruction in COPD (3,6,9) and to measure the changes in lumen and wall of airways 2 mm in diameter and larger (10)(11)(12). Although new-generation CT scanners have the potential for greater resolution without an increase in radiation dose (13,14) and may enable measurements of airways less than 2 mm in diameter, it is not currently possible to resolve the small conducting airways down to the level of the terminal bronchioles.…”

Section: Measurements and Main Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Micro–Computed Tomography Comparison of Preterminal Bronchioles in Centrilobular and Panlobular Emphysema

Tanabe

Vasilescu

McDonough

et al. 2017

Am J Respir Crit Care Med

Self Cite

View full text Add to dashboard Cite

Rationale: Very little is known about airways that are too small to be visible on thoracic multidetector computed tomography but larger than the terminal bronchioles.Objectives: To examine the structure of preterminal bronchioles located one generation proximal to terminal bronchioles in centrilobular and panlobular emphysema.Methods: Preterminal bronchioles were identified by backtracking from the terminal bronchioles, and their centerlines were established along the entire length of their lumens. Multiple cross-sectional images perpendicular to the centerline were reconstructed to evaluate the bronchiolar wall and lumen, and the alveolar attachments to the outer airway walls in relation to emphysematous destruction in 28 lung samples from six patients with centrilobular emphysema, 20 lung samples from seven patients with panlobular emphysema associated with alpha-1 antitrypsin deficiency, and 47 samples from seven control (donor) lungs. Measurements and Main Results:The preterminal bronchiolar length, wall volume, total volume (wall 1 lumen), lumen circularity, and number of alveolar attachments were reduced in both centrilobular and panlobular emphysema compared with control lungs. In contrast, thickening of the wall and narrowing of the lumen were more severe and heterogeneous in centrilobular than in panlobular emphysema. The bronchiolar lumen was narrower in the middle than at both ends, and the decreased number of alveolar attachments was associated with increased wall thickness in centrilobular emphysema.Conclusions: These results provide new information about small airways pathology in centrilobular and panlobular emphysema and show that these changes affect airways that are not visible with thoracic multidetector computed tomography scans but located proximal to the terminal bronchioles in chronic obstructive pulmonary disease.

show abstract

Section: Measurements and Main Resultsmentioning

confidence: 99%

Section: Measurements and Main Resultsmentioning

confidence: 99%

Micro–Computed Tomography Comparison of Preterminal Bronchioles in Centrilobular and Panlobular Emphysema

Tanabe

Vasilescu

McDonough

et al. 2017

Am J Respir Crit Care Med

Self Cite

View full text Add to dashboard Cite

show abstract

“…In addition, 1,383 with CT evidence of lung diseases and/or previous surgery; emphysema, bronchiectasis, pulmonary neoplasm, asbestosis, interstitial lung disease, pneumonia, atelectasis, round atelectasis, pulmonary edema, pneumothorax, pleural effusion, previous infectious sequelae, diffuse pleural thickening, previous pulmonary resection and pleurodesis, were excluded. In matters of emphysema, we only included trace centrilobular emphysema by CT-definable subtypes of chronic obstructive pulmonary disease, which is minimal centrilobular lucencies, occupying <0.5 percent of lung zone (14). Of the remaining 33 with pleural plaques alone on CT, 7 were excluded due to the absence of pulmonary function test (PFT).…”

Section: Study Populationmentioning

confidence: 99%

Quantification of pleural plaques by computed tomography and correlations with pulmonary function: preliminary study

Kim

Kwon

2018

J. Thorac. Dis.

View full text Add to dashboard Cite

“…High-resolution computerized tomography scans can now essentially replace paper-mounted sections to characterize and grade emphysema phenotypes 11,12 (Figures 2B through 4B). Thus, it is not necessary for the pathologist to prepare paper-mounted sections, obviating the need for sledge microtomes and specialized technical processes.…”

Section: Emphysemamentioning

confidence: 99%

The Pathology of Chronic Obstructive Pulmonary Disease: Progress in the 20th and 21st Centuries

Berg

Wright²

2016

Archives of Pathology &Amp; Laboratory Medicine

View full text Add to dashboard Cite

Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and is the fourth leading cause of death worldwide. There has been significant progress in the pathologic description and pathophysiologic analysis of COPD in the 20th and 21st centuries. We review the history, progression, and significance of pathologic alterations in COPD, including emphysematous changes, airway alterations, and vascular alterations. We also indicate what pathologic features of COPD the practicing pathologist should be describing in standard surgical and autopsy specimens.

show abstract

CT-Definable Subtypes of Chronic Obstructive Pulmonary Disease: A Statement of the Fleischner Society

Cited by 488 publications

References 128 publications

Micro–Computed Tomography Comparison of Preterminal Bronchioles in Centrilobular and Panlobular Emphysema

Micro–Computed Tomography Comparison of Preterminal Bronchioles in Centrilobular and Panlobular Emphysema

Quantification of pleural plaques by computed tomography and correlations with pulmonary function: preliminary study

The Pathology of Chronic Obstructive Pulmonary Disease: Progress in the 20th and 21st Centuries

Contact Info

Product

Resources

About