Desquamative interstitial pneumonia may progress to lung fibrosis as characterized radiologically
Article first published online: 25 OCT 2012
© 2012 The Authors. Respirology © 2012 Asian Pacific Society of Respirology
Volume 17, Issue 8, pages 1214–1221, November 2012
How to Cite
KAWABATA, Y., TAKEMURA, T., HEBISAWA, A., SUGITA, Y., OGURA, T., NAGAI, S., SAKAI, F., KANAUCHI, T., COLBY, T. V. and THE DESQUAMATIVE INTERSTITIAL PNEUMONIA STUDY GROUP (2012), Desquamative interstitial pneumonia may progress to lung fibrosis as characterized radiologically. Respirology, 17: 1214–1221. doi: 10.1111/j.1440-1843.2012.02226.x
- Issue published online: 25 OCT 2012
- Article first published online: 25 OCT 2012
- Accepted manuscript online: 17 JUL 2012 08:42AM EST
- Received 2 February 2012; invited to revise 17 March 2012, 4 May 2012; revised 9 April 2012, 8 May 2012; accepted 9 May 2012 (Associate Editor: Toby Maher).
- desquamative interstitial pneumonia;
- interstitial pneumonia;
- surgical lung biopsy
Background and objective: In some patients, desquamative interstitial pneumonia may progress to lung fibrosis. The aim of this study was to assess the long-term radiological follow-up results in patients with desquamative interstitial pneumonia.
Methods: Among 75 patients suspected of having desquamative interstitial pneumonia, 31 who fulfilled the criteria were included in this study. Clinical characteristics at presentation, responses to treatment and long-term follow-up were evaluated.
Results: The 31 patients were predominantly males (94%), and the mean age was 55 years; 93% (28/30) had a history of smoking. The clinical findings included high serum levels of lactate dehydrogenase and immunoglobulin G. Bronchoalveolar lavage (26 patients, 84% of cases) frequently showed an increased percentage of eosinophils (mean 17%). Computed tomography (CT) or high resolution (HR) CT at presentation showed ground glass opacities and/or consolidation in all patients, with one third of patients also showing thin-walled cysts within the ground glass opacities. There was no honeycombing on CT or HRCT scans at presentation. Corticosteroid therapy was effective early in the course of the disease; long-term follow-up (mean 99 months) of 31 patients showed only one death due to progression of the disease, but long-term follow-up of 14 patients (mean 125 months) by HRCT showed the development of new thin-walled cysts and honeycombing in five and lung cancer in four patients, respectively.
Conclusions: In a proportion of patients, desquamative interstitial pneumonia may progress to lung fibrosis with honeycombing on HRCT, despite therapy.