The Characteristic of Transbronchial Lung Cryobiopsy in the Pathological Diagnosis of Hypersensitivity Pneumonitis

被引:0
作者
Ohno, Shuuhei [1 ]
Zaizen, Yoshiaki [1 ,2 ]
Matama, Goushi [1 ]
Chikasue, Tomonori [3 ]
Tokisawa, Saeko [1 ]
Okamoto, Masaki [1 ,4 ,5 ]
Tabata, Kazuhiro [6 ]
Tominaga, Masaki [7 ]
Akiba, Jun [8 ]
Fujimoto, Kiminori [3 ]
Fukuoka, Junya [2 ]
Hoshino, Tomoaki [1 ]
机构
[1] Kurume Univ, Sch Med, Dept Med, Div Respirol, 67 Asahi Machi, Kurume, Fukuoka 8300011, Japan
[2] Nagasaki Univ, Grad Sch Biomed Sci, Dept Pathol Informat, 1-7-1 Sakamoto, Nagasaki 8528501, Japan
[3] Kurume Univ, Sch Med, Dept Radiol, 67 Asahi Machi, Kurume, Fukuoka 8300011, Japan
[4] Natl Hosp Org Kyushu Med Ctr, Dept Respirol, 1-8-1 Jigyouhama,Chuo Ku, Fukuoka 8108563, Japan
[5] Natl Hosp Org Kyushu Med Ctr, Clin Res Ctr, 1-8-1 Jigyouhama,Chuo Ku, Fukuoka 8108563, Japan
[6] Kagoshima Univ, Grad Sch Med & Dent Sci, Dept Pathol, 8-35-1 Sakuragaoka, Kagoshima 8908544, Japan
[7] Kurume Univ, Sch Med, Dept Community Med, 67 Asahi Machi, Kurume, Fukuoka 8300011, Japan
[8] Kurume Univ, Sch Med, Dept Pathol, 67 Asahi Machi, Kurume, Fukuoka 8300011, Japan
关键词
airway-centered interstitial fibrosis; bronchoscope; hypersensitivity pneumonitis; interstitial lung disease; pulmonary fibrosis; IDIOPATHIC PULMONARY-FIBROSIS;
D O I
10.3390/jcm12113663
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Transbronchial lung cryobiopsy (TBLC) has widely used for the diagnosis of diffuse lung disease. However, it remains unclear whether TBLC is useful for the diagnosis in hypersensitivity pneumonitis (HP). Methods: We investigated 18 patients who underwent TBLC and were diagnosed with HP based on pathology or multidisciplinary discussion (MDD). Of the 18 patients, 12 had fibrotic HP (fHP), 2 had non-fibrotic HP (non-fHP) diagnosed with MDD. The remaining 4 patients were diagnosed with fHP by pathology but not by MDD because of clinical features. The radiology and pathology of these cases were compared. Results: All patients with fHP showed radiological findings of inflammation, fibrosis, and airway disease. Conversely, pathology showed fibrosis and inflammation in 11 of 12 cases (92%), but airway disease was significantly less common with 5 cases (42%) (p = 0.014). Non-fHP showed inflammatory cell infiltration mainly in the centrilobule on pathology, which was consistent with radiology. Granulomas were found in 5 patients with HP (36%). In the non-HP group, airway-centered interstitial fibrosis was observed in 3 patients (75%) with pathology. Conclusions: The pathology with TBLC is difficult to evaluate airway disease of HP. We need to understand this characteristic of TBLC to make a MDD diagnosis of HP.
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页数:11
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