Natural history of honeycombing: follow-up of patients with idiopathic pulmonary fibrosis treated with single-lung transplantation

Abstract

Honeycombing is a dynamic process in which the overall trend is represented by a dimensional increase in cystic pattern; however, single cysts may have a different evolution (enlargement, reduction or complications). This behaviour could be explained by the variety of the pathogenetic processes underlying honeycombing, with cysts that may present abnormal communication with the airway, including the development of a check-valve mechanism.

Comparative chest computed tomography findings of non-tuberculous mycobacterial lung diseases and pulmonary tuberculosis in patients with acid fast bacilli smear-positive sputum

“…To our knowledge, the CT finding of bronchiectasis and cystic changes in NTM infection has not been emphasized in the previous studies. Although the radiological evidence of severe bronchiectasis and subsequent cystic changes, which is traditionally described as the honeycomb appearance, usually represents end-stage interstitial fibrosis, it is reported to be a dynamic process and may have different evolution [16,17]. In order to exclude the pre-existing bronchiectasis and cystic changes, the previous films of the four patients with NTM lung diseases demonstrating bronchiectasis and cystic changes were reviewed since the PACS implementation in our institutions from March 2004.…”

Acute worsening of native lung fibrosis after single lung transplantation for pulmonary fibrosis: two case reports

“…In 21 patients who underwent SLT for IPF and were followed for an average of 35 months after transplant, sequential high-resolution chest CT revealed a progressive loss of lung volume and extension of the fibrotic lesions over time in the native lung [ 12 ]. Similarly, in smaller studies retrospectively analyzing 5–13 SLT patients by use of a chest CT scoring system, other investigators described progressive worsening of fibrosis (and decrease in lung volume) in the native lung [ 5 , 6 , 8 ]. In contrast with the usual profile of progressive worsening of lung fibrosis, acute worsening of pulmonary fibrosis in the native lung seems to be much less frequent.…”

“…However, one major drawback of SLT is that recipients are exposed to complications involving the native lung [ 3 , 4 ], such as infection, hemoptysis, pneumothorax, and neoplasia. In patients receiving SLT for idiopathic pulmonary fibrosis (IPF), fibrosis of the native lung usually worsens over time [ 5 – 8 ], with no significant effects on gas exchange [ 9 ]. Here, we describe two recipients of SLT for IPF who exhibited acute worsening of lung fibrosis after an episode of serious viral infection: cytomegalovirus primo-infection in one case and COVID 19 in the other.…”

An autopsy case of idiopathic pulmonary fibrosis with remarkable honeycomb cyst expansion

“…We have reported an autopsy case of IPF in which some honeycomb cysts had expanded remarkably at the end stage of disease. Previous studies have shown that honeycomb cysts in IPF gradually increase in size during the clinical course [ 2 , 3 ]. However, to the best of our knowledge, no reports have mentioned such a rapid cyst expansion in the natural history in IPF.…”

“…The diameter of honeycomb cysts often ranges from 0.3 to 1.0 cm. Although such cysts are known to occasionally expand up to 2.5 cm with disease progression [ 2 , 3 ], the mechanism of cyst expansion is not fully understood [ 4 , 5 ]. In addition, few studies have reported sequential changes in honeycomb cysts from disease onset to the end stage [ 6 ].…”