Histopathologic Comparison of Biopsy with Subsequent Explant/Autopsy in Patients with Interstitial Lung Disease
Anja C Roden, Ronald S Kuzo, David L Levin, Teng Moua, Jay H Ryu, Eunhee S Yi. Mayo Clinic, Rochester, MN
Background: The temporal evolution of histologic features of interstitial lung disease (ILD) is not well characterized. Although literature suggests that for instance cellular non-specific interstitial pneumonia (NSIP) might evolve into fibrotic NSIP, the incidence of that process is unknown. Moreover, sampling might play a role in our ability to correctly diagnose ILD. We studied patients with clinically suspected ILD who underwent biopsy (bx) and subsequent lung transplant or autopsy.
Design: Patients with clinically suspected ILD, a lung bx and a subsequent explant or autopsy were included. Pathology was reviewed by two pulmonary pathologists and a consensus diagnosis was reached. CT scans at the time of bx were reviewed by two thoracic radiologists and a consensus was reached.
Results: 34 patients (19 men, 15 women) with a median age of 56.6 years (range, 25-76) underwent surgical (n=32) or transbronchial bx (n=2) and had a subsequent transplantation (n=21) or autopsy (n=13). Median time between bx and explant/autopsy was 3.8 years (range, 0-24). Tables 1&2 summarize the histologic diagnoses of patients with morphologic progression (n=10, 29.4%) and patients with stable ILD (n=19, 55.9%).
|Hypersensitivity pneumonitis (HP)||Chronic HP||2|
|Focal fibrosis||Usual interstitial pneumonia (UIP)||2||Increase in fibrosis, new honeycomb changes (HC)|
|Emphysema||UIP||1||Lower lobe not biopsied|
|Organizing pneumonia (OP)||Fibrotic NSIP||1|
|OP, fibroblast foci||HC &scarring||1|
|Thickened pleura||Lymphangioleiomyomatosis (LAM)||1|
|Chronic bronchiolitis &granuloma||Bronchiolocentric fibrosis &scarring||1|
|Diagnosis Biopsy/Explant/Autopsy||# Patients|