Imaging in idiopathic pulmonary fibrosis: diagnosis and mimics
Autor(a) principal: | |
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Data de Publicação: | 2019 |
Outros Autores: | , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Clinics |
Texto Completo: | https://www.revistas.usp.br/clinics/article/view/154909 |
Resumo: | Idiopathic pulmonary fibrosis is a chronic disease of unknown etiology that usually has a progressive course and is commonly associated with a poor prognosis. The main symptoms of idiopathic pulmonary fibrosis, including progressive dyspnea and dry cough, are often nonspecific. Chest high-resolution computed tomography is the primary modality used in the initial assessment of patients with suspected idiopathic pulmonary fibrosis and may have considerable influence on subsequent management decisions. The main role of computed tomography is to distinguish chronic fibrosing lung diseases with a usual interstitial pneumonia pattern from those presenting with a non-usual interstitial pneumonia pattern, suggesting an alternative diagnosis when possible. A usual interstitial pneumonia pattern on chest tomography is characterized by the presence subpleural and basal predominance, reticular abnormality honeycombing with or without traction bronchiectasis, and the absence of features suggestive of an alternative diagnosis. Idiopathic pulmonary fibrosis can be diagnosed according to clinical and radiological criteria in approximately 66.6% of cases. Confirmation of an idiopathic pulmonary fibrosis diagnosis is challenging, requiring the exclusion of pulmonary fibroses with known causes, such as asbestosis, connective tissue diseases, drug exposure, chronic hypersensitivity pneumonitis, and other forms of idiopathic interstitial pneumonitis. The histopathological hallmark of usual interstitial pneumonia is a heterogeneous appearance, characterized by areas of fibrosis with scarring and honeycombing alternating with areas of less affected or normal parenchyma. The aim of this article was to review the clinical, radiological, and pathological features of idiopathic pulmonary fibrosis and of diseases that might mimic idiopathic pulmonary fibrosis presentation. |
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Imaging in idiopathic pulmonary fibrosis: diagnosis and mimicsDifferential DiagnosisIdiopathic Pulmonary FibrosisRadiologyPathologyInterstitial Lung DiseasesIdiopathic pulmonary fibrosis is a chronic disease of unknown etiology that usually has a progressive course and is commonly associated with a poor prognosis. The main symptoms of idiopathic pulmonary fibrosis, including progressive dyspnea and dry cough, are often nonspecific. Chest high-resolution computed tomography is the primary modality used in the initial assessment of patients with suspected idiopathic pulmonary fibrosis and may have considerable influence on subsequent management decisions. The main role of computed tomography is to distinguish chronic fibrosing lung diseases with a usual interstitial pneumonia pattern from those presenting with a non-usual interstitial pneumonia pattern, suggesting an alternative diagnosis when possible. A usual interstitial pneumonia pattern on chest tomography is characterized by the presence subpleural and basal predominance, reticular abnormality honeycombing with or without traction bronchiectasis, and the absence of features suggestive of an alternative diagnosis. Idiopathic pulmonary fibrosis can be diagnosed according to clinical and radiological criteria in approximately 66.6% of cases. Confirmation of an idiopathic pulmonary fibrosis diagnosis is challenging, requiring the exclusion of pulmonary fibroses with known causes, such as asbestosis, connective tissue diseases, drug exposure, chronic hypersensitivity pneumonitis, and other forms of idiopathic interstitial pneumonitis. The histopathological hallmark of usual interstitial pneumonia is a heterogeneous appearance, characterized by areas of fibrosis with scarring and honeycombing alternating with areas of less affected or normal parenchyma. The aim of this article was to review the clinical, radiological, and pathological features of idiopathic pulmonary fibrosis and of diseases that might mimic idiopathic pulmonary fibrosis presentation.Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo2019-05-14info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/xmlhttps://www.revistas.usp.br/clinics/article/view/15490910.6061/clinics/2019/e225Clinics; Vol. 74 (2019); e225Clinics; v. 74 (2019); e225Clinics; Vol. 74 (2019); e2251980-53221807-5932reponame:Clinicsinstname:Universidade de São Paulo (USP)instacron:USPenghttps://www.revistas.usp.br/clinics/article/view/154909/150816https://www.revistas.usp.br/clinics/article/view/154909/153391Copyright (c) 2019 Clinicsinfo:eu-repo/semantics/openAccessHochhegger, BrunoMarchiori, EdsonZanon, MatheusRubin, Adalberto SperbFragomeni, RenataAltmayer, StephanCarvalho, Carlos Roberto RibeiroBaldi, Bruno Guedes2019-05-24T13:16:00Zoai:revistas.usp.br:article/154909Revistahttps://www.revistas.usp.br/clinicsPUBhttps://www.revistas.usp.br/clinics/oai||clinics@hc.fm.usp.br1980-53221807-5932opendoar:2019-05-24T13:16Clinics - Universidade de São Paulo (USP)false |
dc.title.none.fl_str_mv |
Imaging in idiopathic pulmonary fibrosis: diagnosis and mimics |
title |
Imaging in idiopathic pulmonary fibrosis: diagnosis and mimics |
spellingShingle |
Imaging in idiopathic pulmonary fibrosis: diagnosis and mimics Hochhegger, Bruno Differential Diagnosis Idiopathic Pulmonary Fibrosis Radiology Pathology Interstitial Lung Diseases |
title_short |
Imaging in idiopathic pulmonary fibrosis: diagnosis and mimics |
title_full |
Imaging in idiopathic pulmonary fibrosis: diagnosis and mimics |
title_fullStr |
Imaging in idiopathic pulmonary fibrosis: diagnosis and mimics |
title_full_unstemmed |
Imaging in idiopathic pulmonary fibrosis: diagnosis and mimics |
title_sort |
Imaging in idiopathic pulmonary fibrosis: diagnosis and mimics |
author |
Hochhegger, Bruno |
author_facet |
Hochhegger, Bruno Marchiori, Edson Zanon, Matheus Rubin, Adalberto Sperb Fragomeni, Renata Altmayer, Stephan Carvalho, Carlos Roberto Ribeiro Baldi, Bruno Guedes |
author_role |
author |
author2 |
Marchiori, Edson Zanon, Matheus Rubin, Adalberto Sperb Fragomeni, Renata Altmayer, Stephan Carvalho, Carlos Roberto Ribeiro Baldi, Bruno Guedes |
author2_role |
author author author author author author author |
dc.contributor.author.fl_str_mv |
Hochhegger, Bruno Marchiori, Edson Zanon, Matheus Rubin, Adalberto Sperb Fragomeni, Renata Altmayer, Stephan Carvalho, Carlos Roberto Ribeiro Baldi, Bruno Guedes |
dc.subject.por.fl_str_mv |
Differential Diagnosis Idiopathic Pulmonary Fibrosis Radiology Pathology Interstitial Lung Diseases |
topic |
Differential Diagnosis Idiopathic Pulmonary Fibrosis Radiology Pathology Interstitial Lung Diseases |
description |
Idiopathic pulmonary fibrosis is a chronic disease of unknown etiology that usually has a progressive course and is commonly associated with a poor prognosis. The main symptoms of idiopathic pulmonary fibrosis, including progressive dyspnea and dry cough, are often nonspecific. Chest high-resolution computed tomography is the primary modality used in the initial assessment of patients with suspected idiopathic pulmonary fibrosis and may have considerable influence on subsequent management decisions. The main role of computed tomography is to distinguish chronic fibrosing lung diseases with a usual interstitial pneumonia pattern from those presenting with a non-usual interstitial pneumonia pattern, suggesting an alternative diagnosis when possible. A usual interstitial pneumonia pattern on chest tomography is characterized by the presence subpleural and basal predominance, reticular abnormality honeycombing with or without traction bronchiectasis, and the absence of features suggestive of an alternative diagnosis. Idiopathic pulmonary fibrosis can be diagnosed according to clinical and radiological criteria in approximately 66.6% of cases. Confirmation of an idiopathic pulmonary fibrosis diagnosis is challenging, requiring the exclusion of pulmonary fibroses with known causes, such as asbestosis, connective tissue diseases, drug exposure, chronic hypersensitivity pneumonitis, and other forms of idiopathic interstitial pneumonitis. The histopathological hallmark of usual interstitial pneumonia is a heterogeneous appearance, characterized by areas of fibrosis with scarring and honeycombing alternating with areas of less affected or normal parenchyma. The aim of this article was to review the clinical, radiological, and pathological features of idiopathic pulmonary fibrosis and of diseases that might mimic idiopathic pulmonary fibrosis presentation. |
publishDate |
2019 |
dc.date.none.fl_str_mv |
2019-05-14 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://www.revistas.usp.br/clinics/article/view/154909 10.6061/clinics/2019/e225 |
url |
https://www.revistas.usp.br/clinics/article/view/154909 |
identifier_str_mv |
10.6061/clinics/2019/e225 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
https://www.revistas.usp.br/clinics/article/view/154909/150816 https://www.revistas.usp.br/clinics/article/view/154909/153391 |
dc.rights.driver.fl_str_mv |
Copyright (c) 2019 Clinics info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Copyright (c) 2019 Clinics |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf application/xml |
dc.publisher.none.fl_str_mv |
Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo |
publisher.none.fl_str_mv |
Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo |
dc.source.none.fl_str_mv |
Clinics; Vol. 74 (2019); e225 Clinics; v. 74 (2019); e225 Clinics; Vol. 74 (2019); e225 1980-5322 1807-5932 reponame:Clinics instname:Universidade de São Paulo (USP) instacron:USP |
instname_str |
Universidade de São Paulo (USP) |
instacron_str |
USP |
institution |
USP |
reponame_str |
Clinics |
collection |
Clinics |
repository.name.fl_str_mv |
Clinics - Universidade de São Paulo (USP) |
repository.mail.fl_str_mv |
||clinics@hc.fm.usp.br |
_version_ |
1800222764091572224 |