Source: Annual Congress 2002 - Interstitial lung disease
Disease area: Interstitial lung diseases

Abstract

The clinical diagnosis of pulmonary emphysema relies on measurements of lung function and the radiological features of the disease. Lung function tests (LFT) typically reveal an obstructive pattern associated with significant increase in TLC and especially RV and decreased DLco. High resolution computed tomography (HRCT), on the other hand, represents a more sensitive method with which to detect emphysema and to determine its extension and severity. Coexistance of emphysema and ground glass opacity (GGO) on HRCT has been reported in smokers (Holt, RA et al. J Comput Assist Tomogr 1993; 17:46-50), and GGO associated with an obstructive-restrictive lung functions has been reported in respiratory bronchiolitis-associated interstitial lung disease (RB-ILD), where the most common CT findings consist of centrilobular micronodules and GGO with upper lobe predominance (King, TE et al. Clin Chest Med 1993; 14:693-98). We present 4 HRCT scans of patients, current heavy smokers, presented with insidious onset of shortness of breath and exercise intolerance. Emphysema was confirmed by HRCT, which, in addition, showed diffuse GGO, but no micronodules. LFTs of those patients reveal an identical combined obstructive-restrictive pattern with slightly diminished FEV1, normal or decreased TLC and RV and merkedly decreased DLco. Images from the four cases will be presented and differential diagnosis discussed. Do the findings in those cases represent a subgroup of RB-ILD or a new disease entity?

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Citations should be made in the following way:
S. Shaker, A. Dirksen, L. Laursen, K. Bach, P. Tonnesen (Hellerup, Denmark). Combined emphysema & interstitial pulmonary disease. A new disease entity?. Eur Respir J 2002; 20: Suppl. 38, 3674

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