Multiple, thin-walled cysts are one of the HRCT features of airspace enlargement with fibrosis

Watanabe, Yasutaka; Kawabata, Yoshinori; Kanauchi, Tetsu; Hoshi, Eishin; Kurashima, Kazuyoshi; Koyama, Shinichiro; Colby, Thomas V.

doi:10.1016/j.ejrad.2015.01.015

Cited by 41 publications

(24 citation statements)

References 19 publications

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“… 21 For a more accurate CT diagnosis, SRIF with pulmonary emphysema must be distinguished from honeycombing. In this respect, Watanabe et al 28 recently reported that the maximum cyst wall thickness of multiple thin-walled cysts was significantly thinner than that of honeycombing. Although we felt the similar tendency regarding wall thickness, the accurate measurement of wall thickness of clustered cysts seems to be difficult practically due to limitation of special resolution of CT.…”

Section: Discussionmentioning

confidence: 98%

Smoking-related interstitial fibrosis combined with pulmonary emphysema: computed tomography-pathologic correlative study using lobectomy specimens

Otani¹,

Tanaka²,

Murata³

et al. 2016

COPD

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PurposeTo evaluate the incidence and pathologic correlation of thin-section computed tomography (TSCT) findings in smoking-related interstitial fibrosis (SRIF) with pulmonary emphysema.Patients and methodsOur study included 172 consecutive patients who underwent TSCT and subsequent lobectomy. TSCT findings including clustered cysts with visible walls (CCVW) and ground-glass attenuation with/without reticulation (GGAR) were evaluated and compared in nonsmokers and smokers and among lung locations. TSCT findings, especially CCVW, were also compared with histological findings using lobectomy specimens.ResultsThe incidence of CCVW and GGAR was significantly higher in smokers than in nonsmokers (34.1% and 40.7%, respectively, vs 2.0% and 12.2%). CCVW and GGAR were frequently found in the lower and peripheral zones. Histologically, CCVW corresponded more often with SRIF with emphysema than usual interstitial pneumonia (UIP, 63.3% vs 30%). CCVW of irregular size and shape were seen in 19 of 20 SRIF with emphysema and in seven of nine UIP-manifested areas with similar round cysts. A less-involved subpleural parenchyma was observed more frequently in SRIF with emphysema.ConclusionSRIF with emphysema is a more frequent pathological finding than UIP in patients with CCVW on TSCT. The irregular size and shape of CCVW and a less-involved subpleural parenchyma may be a clue suggesting the presence of SRIF with emphysema.

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Section: Discussionmentioning

confidence: 98%

Smoking-related interstitial fibrosis combined with pulmonary emphysema: computed tomography-pathologic correlative study using lobectomy specimens

Otani¹,

Tanaka²,

Murata³

et al. 2016

COPD

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“… 23 , 24 Corresponding CT features have been sporadically reported and acknowledged in the latest American Thoracic Society and European Respiratory Society classification of the idiopathic interstitial pneumonias. 9 , 25 Watanabe et al 15 have recently suggested that AEF may be reliably distinguished from honeycombing. In keeping with their findings, signs consistent with AEF were observed either in association with other ILAs or as the predominant ILA.…”

Section: Discussionmentioning

confidence: 99%

“…Findings equivocal for ILA were defined as focal or unilateral ground glass opacity (GGO), focal or unilateral reticulation, and patchy GGO (<5% of the lung); an individual pattern consisting of conspicuous reticular abnormalities admixed with emphysema (termed airspace enlargement with fibrosis [AEF]) was considered as equivocal ILA and individually recorded. 7 , 9 , 15 Definite ILA LDCT features included GGO that affected >5% of any lung zone, nondependent subpleural reticular abnormality, diffuse centrilobular nodularity with or without GGO, honeycombing, traction bronchiectasis, nonemphysematous cysts, or signs of architectural distortion (eg, fissure displacement related to any reticular abnormality). 7 Distribution prevalence was classified as follows: the upper lung zone (when most of the findings were above the level of the tracheal carina), the lower lung zone (when most of the findings were below the level of the tracheal carina), or diffuse.…”

Section: Methodsmentioning

confidence: 99%

Are interstitial lung abnormalities associated with COPD? A nested case–control study

Bozzetti

Paladini

Rabaiotti

et al. 2016

COPD

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PurposeIn this study, we tested the association between COPD and interstitial lung abnormality (ILA), notably in relation to the presence of computed tomography (CT) signs of lung fibrosis.Patients and methodsCOPD cases were selected from participants undergoing lung cancer screening (Multicentric Italian Lung Detection trial) for airflow obstruction (n=311/2,303, 13.5%) and 146 consecutive patients with clinical COPD. In all, 457 COPD cases were selected and classified according to the stages of Global Initiative for Chronic Obstructive Lung Disease. A nested matching (case:control = 1:2) according to age, sex, and smoking history was operated between each COPD case and two control subjects from Multicentric Italian Lung Detection trial without airflow obstruction. Low-dose CT scans of COPD cases and controls were reviewed for the presence of ILA, which were classified into definite or indeterminate according to the presence of signs of lung fibrosis.ResultsThe frequency of definite ILA was similar between COPD cases and controls (P=0.2), independent of the presence of signs of lung fibrosis (P=0.07). Combined definite and indeterminate ILA was homogeneously distributed across Global Initiative for Chronic Obstructive Lung Disease stages (P=0.6). Definite ILA was directly associated with current smoker status (odds ratio [OR] 4.05, 95% confidence interval [CI]: 2.2–7.4) and increasing pack-years (OR 1.01, 95% CI: 1–1.02). Subjects with any fibrotic ILA were more likely to be older (OR 1.17, 95% CI: 1.10–1.25) and male (OR 8.58, 95% CI: 1.58–68.9).ConclusionThere was no association between COPD and definite ILA. However, low-dose CT signs of lung fibrosis were also observed in COPD, and their clinical relevance is yet to be determined.

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“…Previous studies have shown that nonemphysematous cysts usually present as thin-walled, inhomogeneous-sized cysts, and they are characterized by relatively asymmetric distributions and less involvement of the juxta-subpleural parenchyma (Fig. 9) (37)(38)(39). It is one of the imaging features that are predictive of ILA progression (odds ratio: 2.5; 95% CI: 1.3-5.1) and increased mortality (hazard ratio: 1.4; 95% CI: 1.1-1.8) (16), albeit not as strongly as the other features, including reticular markings and traction bronchiectasis.…”

Section: Fibrotic Ilasmentioning

confidence: 99%

Interstitial Lung Abnormalities: What Radiologists Should Know

et al. 2021

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Interstitial lung abnormalities (ILAs) are radiologic abnormalities found incidentally on chest CT that are potentially related to interstitial lung diseases. Several articles have reported that ILAs are associated with increased mortality, and they can show radiologic progression. With the increased recognition of ILAs on CT, the role of radiologists in reporting them is critical. This review aims to discuss the clinical significance and radiologic characteristics of ILAs to facilitate and enhance their management.

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Multiple, thin-walled cysts are one of the HRCT features of airspace enlargement with fibrosis

Cited by 41 publications

References 19 publications

Smoking-related interstitial fibrosis combined with pulmonary emphysema: computed tomography-pathologic correlative study using lobectomy specimens

Smoking-related interstitial fibrosis combined with pulmonary emphysema: computed tomography-pathologic correlative study using lobectomy specimens

Are interstitial lung abnormalities associated with COPD? A nested case–control study

Interstitial Lung Abnormalities: What Radiologists Should Know

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Multiple, thin-walled cysts are one of the HRCT features of airspace enlargement with fibrosis

Cited by 41 publications

References 19 publications

Smoking-related interstitial fibrosis combined with pulmonary emphysema: computed tomography-pathologic correlative study using lobectomy specimens

Smoking-related interstitial fibrosis combined with pulmonary emphysema: computed tomography-pathologic correlative study using lobectomy specimens

Are interstitial lung abnormalities associated with COPD? A nested case&ndash;control study

Interstitial Lung Abnormalities: What Radiologists Should Know

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Are interstitial lung abnormalities associated with COPD? A nested case–control study