Radiographic-Physiologic-Pathologic Correlations in Interstitial Pneumonias1

Gaensler, Edward A.; Carrington, Charles B.; Coutu, Ronald E.; FitzGerald, M. X.

doi:10.1159/000398305

Cited by 47 publications

(19 citation statements)

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“…These findings are consistent with those of Gaensler et al (44), who demonstrated a "fair correlation" between VC and the "overall severity of the anatomic lesion" amoxig a group of patients with IPF, and no correlation with DLCO. Thus VC, TLC, and DLco do not appear to be useful objective monitors of either the degree of fibrosis or the degree ofcellularity in this disease.…”

Section: Discussionsupporting

confidence: 92%

Morphologic-physiologic correlates of the severity of fibrosis and degree of cellularity in idiopathic pulmonary fibrosis.

Fulmer¹,

Roberts²,

Gal³

et al. 1979

J. Clin. Invest.

206

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A B S T R A C T Idiopathic pulmonary fibrosis (IPF) is a progressive disease of lung parenchyma characterized by a chronic inflammatory cellular infiltration and varying degrees of interstitial fibrosis. Current data indicate that the severity of fibrosis and the degree of cellularity determine, in part, the prognosis of IPF and the response to therapy. Whereas lung biopsy gives the best assessment of fibrosis and cellularity, physiologic studies are used to stage and monitor the disease process. To determine which physiologic studies correlate best with severity of fibrosis and degree of cellularity, these parameters were graded in lung biopsies of 23 patients with IPF and compared with a variety of physiologic studies.Although vital capacity, total lung capacity, and diffusing capacity are commonly used as objective monitors of the disease process, none of these parameters correlated with either the severity of fibrosis or the degree of cellularity in biopsy specimens. In contrast, almost all parameters of lung distensibility correlated with the morphologic assessment of degree of fibrosis; compliance had the best correlation. Parameters of distensibility, however, correlated poorly with the degree of cellularity.In comparison, gas exchange during exercise correlated with both morphologic parameters; the exercise-induced changes in arterial oxygen pressure per liter of oxygen consumed had a high correlation with the degree of fibrosis (r = 0.89; P < 0.001) and correlated to a lesser extent with the degree of cellularity (r = 0.56; P = 0.009). In contrast, neither the resting arterial oxygen tension nor the arterial oxygen tension at

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Section: Discussionsupporting

confidence: 92%

Morphologic-physiologic correlates of the severity of fibrosis and degree of cellularity in idiopathic pulmonary fibrosis.

Fulmer¹,

Roberts²,

Gal³

et al. 1979

J. Clin. Invest.

206

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“…This method of quantification of inflammatory cell numbers in relation to alveolar wall thickness and length is time-consuming but has some advantages over semi-quantitative scoring systems evaluated and employed in earlier work [30][31][32][33]; whilst semi-quantitative systems are suitable for making observations of major differences between patient groups, they offer less precision and reproducibility. In a recent study of interobserver variability among experienced histopathologists, the kappa coefficients of agreement varied from -0.06 to 0.30; for most variables, agreement between observers in assigning a semi-quantitative grade was little higher than that expected by chance [30].…”

Section: Discussionmentioning

confidence: 99%

Fibrosing alveolitis in systemic sclerosis: increase in memory T-cells in lung interstitium

Wells¹,

Lorimer²,

Majumdar³

et al. 1995

Eur Respir J

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“…This might be explained by stretching of intercellular junctions through which 99m Tc-DTPA crosses the respiratory epithelium, and which renders the respiratory membrane more permeable to solutes [17]. Mechanical stretching of the respiratory epithelium probably occurs in DFA, where the decrease in VC appears to correlate closely with the degree of lung fibrosis and lung recoil [35][36][37].…”

Section: Discussionmentioning

confidence: 99%

Mechanisms of increased epithelial lung clearance of DTPA in diffuse fibrosing alveolitis

Labrune

Chinet²,

Collignon³

et al. 1994

Eur Respir J

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The aim of this study was to elucidate possible mechanisms of increased epithelial lung clearance in diffuse fibrosing alveolitis (DFA). We investigated the relationships between epithelial lung clearance as assessed by the clearance of aerosolized 99mTc-diethylene-triamine-penta-acetic acid (RC-DTPA), luminal alveolitis as assessed by bronchoalveolar lavage, and pulmonary function, in 30 nonsmokers with DFA. In 14 of these patients, RC-DTPA and lung function were determined before and during therapy with prednisolone (0.5 mg.kg-1 daily). RC-DTPA was higher in patients with DFA (4.45 +/- 2.50%.min-1) than in normal subjects (1.18 +/- 0.31%.min-1). RC-DTPA did not correlate with the number of alveolar neutrophils, but correlated positively with the number of alveolar lymphocytes, and negatively with vital capacity (VC). RC-DTPA decreased from 6.1 +/- 2.8 to 3.8 +/- 1.9%.min-1 with prednisolone. RC-DTPA before prednisolone correlated positively with the prednisolone-associated improvement in VC. We conclude that in patient with DFA, RC-DTPA is increased, and decreases but does not return to normal with corticosteroid therapy. Our data suggest that in DFA the increase in RC-DTPA could be related to the recoil-induced stretch of the respiratory epithelium and to alveolar lymphocytic inflammation.

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Radiographic-Physiologic-Pathologic Correlations in Interstitial Pneumonias1

Cited by 47 publications

References 0 publications

Morphologic-physiologic correlates of the severity of fibrosis and degree of cellularity in idiopathic pulmonary fibrosis.

Morphologic-physiologic correlates of the severity of fibrosis and degree of cellularity in idiopathic pulmonary fibrosis.

Fibrosing alveolitis in systemic sclerosis: increase in memory T-cells in lung interstitium

Mechanisms of increased epithelial lung clearance of DTPA in diffuse fibrosing alveolitis

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