Smoking-related intersticial fibrosis (srif): A new entity?
E. De Freitas Gonzalez (León, Spain), J. Villegas Alcázar (León, Spain), R. Almeida Cabrera (León, Spain), C. Mier Bango (León, Spain), L. Sierra Herranz (León, Spain), J. Juan García (León, Spain), I. Herráez Ortega (León, Spain), N. Alonso Orcajo (León, Spain), S. García García (León, Spain), E. Bollo De Miguel (León, Spain)
Source: International Congress 2018 – Pitfalls in the diagnosis and management of rare diffuse parenchymal lung diseases (DPLDs)
Disease area: Interstitial lung diseases
Abstract INTRODUCTION:SRIF was described as changes in lung parenchyma (hyalinized interstitial fibrosis, alveolar septal thickening, emphysema and respiratory bronchiolitis-RB) in lobectomy specimens from smokers with cancer and eventually by HRCT (ground-glass attenuation, reticulation and thick-walled cysts without traction bronchiectasis or parenchymal distortion)
OBJECTIVES:To describe a group of SRIF patients as associated with interstitial lung disease (ILD) and/or emphysema
METHODS:Retrospective study on SRIF patients diagnosed in ILD consult since 2016 by HRCT. The variables included:age, sex, smoking habit, HRCT findings, spirometry, DLCO, pulmonary biopsy and diagnosis
RESULTS:30 patients (28 ?,2 ?); mean age 69; 80% ex-smokers, 20% current smokers. All underwent HRTC with findings of SRIF and another ILD in most cases (Table 1). Spirometry pattern was obstructive in 11, non-obstructive in 3 and normal in 14. DLCO was low in 26 (mild 9, moderate 13, severe 4). Out of 4 pulmonary biopsies (1 transbronchial and 3 surgical) SRIF was found in the surgical ones. Final diagnoses: ILD 19 (Table 2), COPD and/or emphysema 17. In 17 patients SRIF was associated with other smoking related-ILD:9 CPFE, 5 RB-ILD, 2 pulmonary LCH, 1 RA-ILD. 21 patients were evaluated in ILD multidisciplinary meeting
CONCLUSIONS:1-Radiologists must consider SRIF on performing HRCT on smokers or ex-smokers. 2-SRIF may coexist with multiple HRCT patterns of smoking-related ILD
TABLE 1-HRTC PATTERN
Patients
UIP
5
Possible UIP
1
Inconsistent UIP
3
NSIP
3
RB-ILD
5
Pulmonary LCH
2
TABLE 2-ILD diagnosis
Patients
CPFE (RA-ILD)
1
CPFE (IPF)
5
CPFE (NSIP)
1
CPFE (HP)
1
CPFE (Unclassifiable IIP)
1
IPAF
2
RB-ILD
5
Unclassifiable IIP
1
Pneumoconiosis
1
RA-ILD
1
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E. De Freitas Gonzalez (León, Spain), J. Villegas Alcázar (León, Spain), R. Almeida Cabrera (León, Spain), C. Mier Bango (León, Spain), L. Sierra Herranz (León, Spain), J. Juan García (León, Spain), I. Herráez Ortega (León, Spain), N. Alonso Orcajo (León, Spain), S. García García (León, Spain), E. Bollo De Miguel (León, Spain). Smoking-related intersticial fibrosis (srif): A new entity?. 3031
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