Clinical, radiologic, and morphological diagnosis of hypersensitivity pneumonitis
Aim. To study the relationship between clinical, radiologic, and morphological features in nonfibrotic and fibrotic hypersensitivity pneumonitis.Materials and methods. Clinical symptoms, data of high-resolution computed tomography, parameters of external respiration, and histological changes in the...
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| Format: | Article |
| Language: | English |
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Siberian State Medical University (Tomsk)
2022-01-01
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| Series: | Бюллетень сибирской медицины |
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| Online Access: | https://bulletin.ssmu.ru/jour/article/view/4586 |
| _version_ | 1797872768943915008 |
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| author | A. L. Cherniaev E. V. Kusraeva M. V. Samsonova S. N. Avdeev N. V. Trushenko E. L. Tumanova |
| author_facet | A. L. Cherniaev E. V. Kusraeva M. V. Samsonova S. N. Avdeev N. V. Trushenko E. L. Tumanova |
| author_sort | A. L. Cherniaev |
| collection | DOAJ |
| description | Aim. To study the relationship between clinical, radiologic, and morphological features in nonfibrotic and fibrotic hypersensitivity pneumonitis.Materials and methods. Clinical symptoms, data of high-resolution computed tomography, parameters of external respiration, and histological changes in the lung tissue obtained via open and transbronchial biopsies were studied retrospectively in 175 patients with hypersensitivity pneumonitis (HP). Statistical analysis was performed using the Statistica software.Results. We found that the clinical error rate in the diagnosis of HP was 84.5%, among pathologists – 92%. Among all the variants of HP, the most common was fibrotic HP. It was shown that non-necrotizing granulomas and giant cells in the cavities of the alveoli, microcells, and interalveolar septa were more typical of nonfibrotic HP. In fibrotic HP, peribronchial fibrosis, smooth muscle metaplasia in fibrotic areas, and the presence of fibroblastic foci in the walls of terminal bronchioles are signs of differential diagnosis with usual interstitial pneumonia. The classical triad of histological signs was observed in 19.2% of patients with nonfibrotic HP and in 5.6% of patients with fibrotic HP.Conclusion. Diagnosis of HP is complex and should be based on a multidisciplinary approach involving clinicians (pulmonologists), radiologists, functional diagnostics specialists, and pathologists. In this case, it is imperative to take into account and identify factors causing development of the disease, as well as the age of patients. |
| first_indexed | 2024-04-10T01:05:22Z |
| format | Article |
| id | doaj.art-808ad00a4e6944149d061ad2d4f52416 |
| institution | Directory Open Access Journal |
| issn | 1682-0363 1819-3684 |
| language | English |
| last_indexed | 2024-04-10T01:05:22Z |
| publishDate | 2022-01-01 |
| publisher | Siberian State Medical University (Tomsk) |
| record_format | Article |
| series | Бюллетень сибирской медицины |
| spelling | doaj.art-808ad00a4e6944149d061ad2d4f524162023-03-13T09:58:27ZengSiberian State Medical University (Tomsk)Бюллетень сибирской медицины1682-03631819-36842022-01-012049310210.20538/1682-0363-2021-4-93-1022845Clinical, radiologic, and morphological diagnosis of hypersensitivity pneumonitisA. L. Cherniaev0E. V. Kusraeva1M. V. Samsonova2S. N. Avdeev3N. V. Trushenko4E. L. Tumanova5Научно-исследовательский институт (НИИ) пульмонологии; Научно-исследовательский институт морфологии человека (НИИМЧ) имени академика А.П. АвцынаРоссийский национальный исследовательский медицинский университет (РНИМУ) имени Н.И. ПироговаНаучно-исследовательский институт морфологии человека (НИИМЧ) имени академика А.П. Авцына; Московский клинический научно-практический центр имени А.С. Логинова Департамента здравоохранения города МосквыПервый Московский государственный медицинский университет имени И.М. Сеченова (Сеченовский университет)Первый Московский государственный медицинский университет имени И.М. Сеченова (Сеченовский университет); НИИ пульмонологииРоссийский национальный исследовательский медицинский университет (РНИМУ) имени Н.И. ПироговаAim. To study the relationship between clinical, radiologic, and morphological features in nonfibrotic and fibrotic hypersensitivity pneumonitis.Materials and methods. Clinical symptoms, data of high-resolution computed tomography, parameters of external respiration, and histological changes in the lung tissue obtained via open and transbronchial biopsies were studied retrospectively in 175 patients with hypersensitivity pneumonitis (HP). Statistical analysis was performed using the Statistica software.Results. We found that the clinical error rate in the diagnosis of HP was 84.5%, among pathologists – 92%. Among all the variants of HP, the most common was fibrotic HP. It was shown that non-necrotizing granulomas and giant cells in the cavities of the alveoli, microcells, and interalveolar septa were more typical of nonfibrotic HP. In fibrotic HP, peribronchial fibrosis, smooth muscle metaplasia in fibrotic areas, and the presence of fibroblastic foci in the walls of terminal bronchioles are signs of differential diagnosis with usual interstitial pneumonia. The classical triad of histological signs was observed in 19.2% of patients with nonfibrotic HP and in 5.6% of patients with fibrotic HP.Conclusion. Diagnosis of HP is complex and should be based on a multidisciplinary approach involving clinicians (pulmonologists), radiologists, functional diagnostics specialists, and pathologists. In this case, it is imperative to take into account and identify factors causing development of the disease, as well as the age of patients.https://bulletin.ssmu.ru/jour/article/view/4586нефиброзный и фиброзный гиперчувствительный пневмонитмультидисциплинарная диагностикагистологические признаки |
| spellingShingle | A. L. Cherniaev E. V. Kusraeva M. V. Samsonova S. N. Avdeev N. V. Trushenko E. L. Tumanova Clinical, radiologic, and morphological diagnosis of hypersensitivity pneumonitis Бюллетень сибирской медицины нефиброзный и фиброзный гиперчувствительный пневмонит мультидисциплинарная диагностика гистологические признаки |
| title | Clinical, radiologic, and morphological diagnosis of hypersensitivity pneumonitis |
| title_full | Clinical, radiologic, and morphological diagnosis of hypersensitivity pneumonitis |
| title_fullStr | Clinical, radiologic, and morphological diagnosis of hypersensitivity pneumonitis |
| title_full_unstemmed | Clinical, radiologic, and morphological diagnosis of hypersensitivity pneumonitis |
| title_short | Clinical, radiologic, and morphological diagnosis of hypersensitivity pneumonitis |
| title_sort | clinical radiologic and morphological diagnosis of hypersensitivity pneumonitis |
| topic | нефиброзный и фиброзный гиперчувствительный пневмонит мультидисциплинарная диагностика гистологические признаки |
| url | https://bulletin.ssmu.ru/jour/article/view/4586 |
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