Yetkin AGAÇKIRAN, Nazire UÇAR, Sibel Meryem ALPAR, Özlem KURT KAR, Emine Bahar KURT, Hakan ERTÜRK, Funda DEMİRAĞ

Usual interstisyel pnömoninin radyolojik özellikleri ile histopatolojik görünümünün karşılaştırılması

Pulmoner fibrozisin histolojik bulguları, yüksek çözünürlüklü bilgisayarlı tomografideki YRBT radyolojik bulgular ile kuvvetle ilişkilidir ve aynı zamanda buzlu cam görünümü, interstisyel inflamasyon ile ilişkilidir. Biz, usual interstisyel pnömoni UİP olan hastalarda YRBT bulguları ile histolojik korelasyonu araştırmayı amaçladık. Yöntem: Açık akciğer biyopsisi ile UIP tanısı teyit edilen hastaların kayıtları retrospektif olarak incelendi. Semptomların süresi, fizik muayene bulguları, solunum fonksiyon ve difüzyon testi sonuçları ve arteriyel kan gazı analizi sonuçları kaydedildi. İki deneyimli patolog tarafından, tanının teyidi için patoloji örnekleri ATS / ERS kriterleri göz önüne alınarak tekrar incelendi. YRBT görüntüleri de bir radyolog tarafından tekrar değerlendirildi. Klinik, histopatolojik ve radyolojik bulgular kaydedildi ve karşılaştırıldı. Bulgular: UIP patolojik tanısı olan on hastanın hepsinde mikroskobik bal peteği görünümü vardı. HRCT'de bal peteği görünümü 9 hastada gözlendi, bunların 3 tanesinde kistik oluşumda vardı. Mikroskobik incelemede fibroblastik odakları olan hastalarda HRCT'de traksiyon bronşektazisi vardı. Sonuç: YRBT bulguları, UIP’li hastalarda mikroskobik bal peteği görünümünü ve fibroblastik odakların varlığını tahminde yardımcı olabilir. Semptomların süresi ile histolojik değişikliklerin derecesi ilişkili değildir.

Anahtar Kelimeler:

İdiyopatik pulmoner fibrozis, radyolojik özellikler, histopatolojik özellikler.

A Comparison of Histopathological Appearance with Radiological Characteristics of Usual Interstitial Pneumonia

Histological findings of pulmonary fibrosis correlate strongly with radiological findings on highresolution computed tomography HRCT and pure groundglass attenuation correlates with interstitial inflammation. We aimed to investigate histological correlation with HRCT findings in patients with usual interstitial pneumonia UIP . Method: The records of patients with UIP confirmed with an open lung biopsy were retrospectively reviewed. Duration of symptoms, findings on physical examination, pulmonary function and diffusion test results, and results of arterial blood gas analysis were recorded. Pathology specimens were reexamined by two experienced pathologists for confirmation of the diagnosis taking into consideration ATS/ERS criteria. HRCT images were also reevaluated by a designated radiologist. Clinical, histopathological and radiological findings were recorded and compared. Results: Ten patients had a pathological diagnosis of UIP, all of which also had a microscopic honey comb appearance. Honey comb appearance on HRCT was observed in only 9 patients, 3 of which also had cystic formation. Patients with fibroblastic foci on microscopic examination also had traction bronchiectasis on HRCT. Conclusion: HRCT findings may help predict the presence of microscopic honeycomb appearance and fibroblastic foci consistent with UIP. Duration of symptoms and degree of histological changes are not correlated.

Keywords:

idiopathic pulmonary fibrosis, radiological characteristics, histopatholological characteristics.,

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