Specific diagnosis by CT and HRCT in six chronic lung diseases

Potente, G; Bellelli, A; Nardis, P F

doi:10.1016/0895-6111(92)90030-d

Cited by 12 publications

(6 citation statements)

References 14 publications

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“…CT has higher sensitivity for detecting ILD features and is the imaging modality of choice [ 45 , 118 ]. The main limitations are exposure to ionising radiation, an issue minimised with modern scanners and the use of iterative reconstruction.…”

Section: Resultsmentioning

confidence: 99%

Drug-Induced Interstitial Lung Disease: A Systematic Review

Skeoch

Weatherley

Swift

et al. 2018

JCM

265

241

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Background: Drug-induced interstitial lung disease (DIILD) occurs as a result of numerous agents, but the risk often only becomes apparent after the marketing authorisation of such agents. Methods: In this PRISMA-compliant systematic review, we aimed to evaluate and synthesise the current literature on DIILD. Results: Following a quality assessment, 156 full-text papers describing more than 6000 DIILD cases were included in the review. However, the majority of the papers were of low or very low quality in relation to the review question (78%). Thus, it was not possible to perform a meta-analysis, and descriptive review was undertaken instead. DIILD incidence rates varied between 4.1 and 12.4 cases/million/year. DIILD accounted for 3–5% of prevalent ILD cases. Cancer drugs, followed by rheumatology drugs, amiodarone and antibiotics, were the most common causes of DIILD. The radiopathological phenotype of DIILD varied between and within agents, and no typical radiological pattern specific to DIILD was identified. Mortality rates of over 50% were reported in some studies. Severity at presentation was the most reliable predictor of mortality. Glucocorticoids (GCs) were commonly used to treat DIILD, but no prospective studies examined their effect on outcome. Conclusions: Overall high-quality evidence in DIILD is lacking, and the current review will inform larger prospective studies to investigate the diagnosis and management of DIILD.

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Section: Resultsmentioning

confidence: 99%

Drug-Induced Interstitial Lung Disease: A Systematic Review

Skeoch

Weatherley

Swift

et al. 2018

JCM

265

241

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“…Despite the fact that several hundreds of drugs are able to cause DIILD, there are no efficient biomarkers to date for diagnostic or prognostic purposes (Biomarkers Definitions Working Group, 2001;Sullivan et al, 2015;FNB Working Group, 2016;Pneumotox, 2020;Tristan, 2020). To develop biomarkers that are non-invasive, yet able to detect disease onset and progression as early as possible, IBs have been suggested as a prominent tool.…”

Section: Introductionmentioning

confidence: 99%

Imaging Biomarkers and Pathobiological Profiling in a Rat Model of Drug-Induced Interstitial Lung Disease Induced by Bleomycin

Persson

Håkansson²,

Örbom

et al. 2020

Front. Physiol.

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A large number of systemically administered drugs have the potential to cause druginduced interstitial lung disease (DIILD). We aim to characterize a model of DIILD in the rat and develop imaging biomarkers (IBs) for detection and quantification of DIILD. In this study, Sprague-Dawley rats received one single dose of intratracheal (i.t.) bleomycin and were longitudinally imaged at day 0, 3, 7, 14, 21, and 28 post dosing, applying the imaging techniques magnetic resonance imaging (MRI) and positron emission tomography (PET)/computed tomography (CT). Bronchoalveolar lavage fluid (BALF) was analyzed for total protein and inflammatory cells. Lungs were saved for further evaluation by gene analysis using quantitative-PCR and by histology. Lung sections were stained with Masson's-Trichrome staining and evaluated by modified Ashcroft score. Gene expression profiling of inflammatory and fibrotic markers was performed on lung tissue homogenates. Bleomycin induced significant increase in total protein concentration and total cell count in bronchoalveolar lavage (BAL), peaking at day 3 (p > 0.001) and day 7 (p > 0.001) compared to control, respectively. Lesions measured by MRI and PET signal in the lungs of bleomycin challenged rats were significantly increased during days 3-14, peaking at day 7. Two subgroups of animals were identified as low-and highresponders by their different change in total lung volume. Both groups showed signs of inflammation initially, while at later time points, the low-responder group recovered toward control, and the high-responder group showed sustained lung volume increase, and significant increase of lesion volume (p < 0.001) compared to control. Lastly, important inflammatory and pro-fibrotic markers were assessed from lung tissue, linking observed imaging pathological changes to gene expression patterns. In conclusion, bleomycin-induced lung injury is an adequate animal model for DIILD studies and for translational lung injury assessment by MRI and PET imaging. The scenario comprised disease responses, with different fractions of inflammation and fibrosis. Thereby, this study improved the understanding of imaging and biological biomarkers in DIILD and lung injury.

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“…Transitional-cell carcinoma is known to spread along large structures such as the ureter and major vessels, but pulmonary lymphangitic carcinomatosis is highly unusual. Moreover, lymphangitic carcinomatosis characteristically produces irregular, coarse, bronchovascular markings and a peripheral octagonal pattern as the growing tumor accentuates the secondary interlobular septa 6 -findings not present on this patient's radiographs. Although I believe that this patient had transitionalcell carcinoma metastatic to the lung, the acute clin- ical deterioration and dramatic radiographic progression suggest another process.…”

Section: Metastatic Transitional-cell Carcinomamentioning

confidence: 66%

Case 13-2002

Markowitz¹,

Mark²

2002

N Engl J Med

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A 43-year-old man was admitted to the hospital because of hemoptysis and dyspnea.The patient had been well until 28 months earlier, when pain in the right flank and hematuria developed. Cytologic examination of the urine showed malignant tumor cells. An intravenous urographic study revealed a tumor in the right ureter and renal pelvis. A computed tomographic (CT) scan of the abdomen disclosed no evidence of metastatic disease. A right nephroureterectomy was performed, with a finding of grade 3 (poorly differentiated), papillary transitional-cell carcinoma that involved the ureter and renal pelvis; the tumor was classified as stage T3, N0. A CT scan of the chest, obtained postoperatively, showed a small right-sided pleural effusion but no other abnormalities. Twenty-five months before the current admission, adjuvant chemotherapy consisting of four cycles of cisplatin, methotrexate, and vinblastine was begun; it was completed four months later. A thoracic CT scan obtained 17 months before admission revealed no abnormalities. An abdominal and pelvic CT scan showed surgical clips and evidence of the right nephrectomy. The detection of several small lymph nodes in the aortocaval space suggested the presence of metastasis. No other abnormalities were observed.Fourteen months before the current admission, an abdominal and pelvic CT scan revealed abnormal numbers of lymph nodes, all less than 1 cm in diameter; no other abnormality was detected. A repeated CT scan obtained four months later disclosed a softtissue density that surrounded the celiac axis and the origin of the superior mesenteric artery. The multi-ple paraaortic lymph nodes were larger and more numerous than on the previous scan, and there was nonhomogeneous enhancement of the liver, a finding consistent with the presence of fatty infiltration but not metastatic disease. No other abnormalities were detected. Chest radiographs showed no abnormalities.Nine months before admission, examination of a specimen of the largest lymph node (obtained by CT-guided needle biopsy) disclosed metastatic transitional-cell carcinoma. A thoracic CT scan revealed a new parenchymal opacity, 1.5 by 2.0 cm, in the lingula at the left diaphragm. An abdominal and pelvic CT scan revealed lymph nodes as large as 2.4 by 1.6 by 3.5 cm; they extended along the aorta to the level of the superior mesenteric artery and celiac axis. Tumor surrounded the mesenteric vessels and extended to the hepatic portal, and there were changes that suggested the presence of intrahepatic thrombosis in several branches of the right portal vein.Eight months before admission, an indwelling central venous catheter was inserted, and investigational chemotherapy was begun; the regimen consisted of paclitaxel, gemcitabine, and dexamethasone given in 12 doses over about a 24-week period. Four months before admission, a thoracic CT scan revealed a platelike opacity, 1.9 by 0.7 cm, in the left lower lobe; it was suspected to represent subsegmental atelectasis or scarring. No mediastinal or hilar lymphadenopathy or m...

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Specific diagnosis by CT and HRCT in six chronic lung diseases

Cited by 12 publications

References 14 publications

Drug-Induced Interstitial Lung Disease: A Systematic Review

Drug-Induced Interstitial Lung Disease: A Systematic Review

Imaging Biomarkers and Pathobiological Profiling in a Rat Model of Drug-Induced Interstitial Lung Disease Induced by Bleomycin

Case 13-2002

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