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This Article Full Text (PDF) Free All Versions of this Article: chest.06-2553v1 131/6/1870    most recent Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to My Personal Article Archive Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Arakawa, H. Articles by Suganuma, N. Search for Related Content PubMed PubMed Citation Articles by Arakawa, H. Articles by Suganuma, N.

Chronic Interstitial Pneumonia in Silicosis and Mix-Dust Pneumoconiosis: Its prevalence and comparison of CT findings with idiopathic pulmonary fibrosis

¹ Department of Radiology, Dokkyo University School of Medicine ² Department of Radiology, Osaka University Graduate School of Medicine ³ Department of Pathology, Dokkyo University School of Medicine ⁴ Department of Respiratory Medicine, Rosai Hospital for Silicosis ⁵ Department of Radiology, Rosai Hospital for Silicosis ⁶ Department Pulmonary Medicine and Clinical Immunology ⁷ Department of Environmental Health, Fukui Medical University

arakawa{at}dokkyomed.ac.jp

Abstract

BackgroundIncreased prevalence of chronic interstitial pneumonia (CIP) is reported in dust-exposed subjects. We investigated the prevalence of CIP in silicosis and mixed-dust pneumoconiosis and sought morphologic differences of CIP between the pneumoconiosis and idiopathic pulmonary fibrosis (IPF).

MethodsWe reviewed CT scans of 243 silicosis and mixed-dust pneumoconiosis patients to identify any cases of parenchymal lung lesions showing CIP pattern, and compared the CT findings with those of 62 patients with IPF. Two observers independently scored CT images and classified the CT pattern as typical or not typical for IPF. Differences were sought between the groups using a non-parametric test, Fisher's exact test, and a logistic regression analysis. A radiopathologic correlation was performed in 11 pneumoconiosis patients.

ResultsTwenty-eight (11.5%) patients showed CIP on CT. Seven (25%) patients showed a pattern not typical of IPF, while the remaining patients showed a pattern typical of IPF, 11 of which were pathologically confirmed. Extent of fibrosis did not differ between the groups; however, patients with pneumoconiosis showed less traction bronchiectasis (odds ratio, 0.19; 95% CI: 0.08, 0.48; p < 0.001), more subpleural homogeneous attenuation (odds ratio, 2.56; 95% CI: 1.55, 4.23; p < 0.001), and fibrosis was more randomly distributed (odds ratio, 315.38; 95% CI: 4.68, 21244.63; p = 0.007). Pathologically, subpleural homogeneous attenuation corresponded to dense fibrosis often with abundant silicotic nodules.

ConclusionsPrevalence of CIP in pneumoconiosis was about 12% on CT. One quarter of patients showed atypical IPF pattern, and the others showed typical IPF pattern.

Key Words: Lung diseases, interstitial • Pneumoconiosis • Pulmonary fibrosis • Computed tomography, X-ray