Fibrosis in emphysema: Radiologically occult but histologically prevalent process proportionate to smoking burden
A. Fabre, N. Faheem, J. Dodd, M. Narski, A. Treacy, D. Healy, I. Lawrie, T. Finucane, M. Keane, J. Egan, M. Tolan, G. Jebrak, H. Mal, M. Butler (Dublin, Ireland; Paris, France)
Source: International Congress 2014 – ILDs 6
Session: ILDs 6
Session type: Thematic Poster Session
Number: 3800
Disease area: Airway diseases, Interstitial lung diseases
Abstract Interstitial fibrosis with emphysema [also called smoking-related interstitial fibrosis (SRIF), or airspace enlargement with fibrosis] is increasingly recognised, described with co-existing lung cancer. .We undertook a prospective clinical, radiological and pathological analysis of non-cancerous lung from lung cancer resections (n=20), assessing smoking history, fibrosis and small airway changes by histology (see Katzeinstein AL et al 2010) and by protocol-derived high resolution CT (HRCT).Histological emphysema-associated interstitial fibrosis (SRIF) was found in 40%, distant to the lung cancer and associated with small airway changes.Gender and age distribution was similar in both SRIF and non-SRIF subjects, with SRIF observed in 87.5% in the right lung, (62.5% in the right upper lobe), and associated with decreased forced expiratory volume in 1 second (p=0.0026). In all, SRIF had no HRCT correlate.We assessed the histological findings in explanted lungs from radiologic emphysema subjects [n=20 chronic obstructive pulmonary disease (COPD), mean cigarette pack-years (PY)=45; n=20 alpha 1-antitrypsin deficiency (A1AT), mean PY=25]; SRIF was observed in 40% of COPD and 25% of A1AT (linear correlation with mean PY).In summary, histologic fibrosis with emphysema is radiologically occult, highly prevalent, with a dose-response relationship to smoking, and independent of the cancer in the nearby lung.
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A. Fabre, N. Faheem, J. Dodd, M. Narski, A. Treacy, D. Healy, I. Lawrie, T. Finucane, M. Keane, J. Egan, M. Tolan, G. Jebrak, H. Mal, M. Butler (Dublin, Ireland; Paris, France). Fibrosis in emphysema: Radiologically occult but histologically prevalent process proportionate to smoking burden. Eur Respir J 2014; 44: Suppl. 58, 3800
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