Skip to main content
Top
Published in: Japanese Journal of Radiology 3/2019

01-03-2019 | Tuberculosis | Original Article

Pleuroparenchymal fibroelastosis-like lesions on chest computed tomography in routine clinical practice

Authors: Hiromitsu Sumikawa, Takeshi Johkoh, Tae Iwasawa, Katsuyuki Nakanishi, Noriyuki Tomiyama

Published in: Japanese Journal of Radiology | Issue 3/2019

Login to get access

Abstract

Purpose

To evaluate the incidence and changes in the pleuroparenchymal fibroelastosis (PPFE)-like lesions on chest CT in routine clinical practice.

Materials and methods

This study included 1284 patients who underwent chest CT in 2011 at a hospital. The incidence of PPFE-like lesions and their correlation with age, body mass index, and concomitant pulmonary findings were assessed. Moreover, predictors of lesion progression were evaluated on follow-up. The ethical review board waived the requirement of informed consent for the retrospective review of patient records.

Results

In total, 397 (30.9%) of the 1284 patients presented with PPFE-like lesions. The presence of PPFE-like lesions was correlated with older age (mean 72.2 vs. 69.9 years, p = 0.002); lower BMI (mean 21.0 vs. 23.2, p < 0.001); and interstitial pneumonia (64.8%, p < 0.001), emphysema (40.4%, p < 0.001), chronic airway disease (64.8%, p < 0.001), and old tuberculosis (56.5%, p < 0.001). Multivariate analysis of the follow-up CT findings revealed that interstitial pneumonia, nodular opacity, and lesion thickness affected progression (odds ratio: 3.81, 3.78 and 1.21), respectively.

Conclusion

Pleuroparenchymal fibroelastosis-like lesions were not rare and correlated with interstitial pneumonia, emphysema, chronic airway disease, and old tuberculosis. On follow-up, PPFE-like lesions in some patients with concomitant interstitial pneumonia exhibited progression.
Literature
1.
go back to reference Travis WD, Costabel U, Hansell DM, King TE Jr, Lynch DA, Nicholson AG, et al. An official American Thoracic Society/European Respiratory Society statement: update of the international multidisciplinary classification of the idiopathic interstitial pneumonias. Am J Respir Crit Care Med. 2013;188(6):733–48.CrossRefPubMedPubMedCentral Travis WD, Costabel U, Hansell DM, King TE Jr, Lynch DA, Nicholson AG, et al. An official American Thoracic Society/European Respiratory Society statement: update of the international multidisciplinary classification of the idiopathic interstitial pneumonias. Am J Respir Crit Care Med. 2013;188(6):733–48.CrossRefPubMedPubMedCentral
2.
go back to reference Amitani R, Niimi A, Kuze F. Idiopathic pulmonary upper lobe fibrosis (IPUF). Kokyu. 1992;11:693–9. Amitani R, Niimi A, Kuze F. Idiopathic pulmonary upper lobe fibrosis (IPUF). Kokyu. 1992;11:693–9.
3.
go back to reference Frankel SK, Cool CD, Lynch DA, Brown KK. Idiopathic pleuroparenchymal fibroelastosis: description of a novel clinicopathologic entity. Chest. 2004;126(6):2007–13.CrossRefPubMed Frankel SK, Cool CD, Lynch DA, Brown KK. Idiopathic pleuroparenchymal fibroelastosis: description of a novel clinicopathologic entity. Chest. 2004;126(6):2007–13.CrossRefPubMed
4.
go back to reference Piciucchi S, Tomassetti S, Casoni G, Sverzellati N, Carloni A, Dubini A, et al. High resolution CT and histological findings in idiopathic pleuroparenchymal fibroelastosis: features and differential diagnosis. Respir Res. 2011;12:111.CrossRefPubMedPubMedCentral Piciucchi S, Tomassetti S, Casoni G, Sverzellati N, Carloni A, Dubini A, et al. High resolution CT and histological findings in idiopathic pleuroparenchymal fibroelastosis: features and differential diagnosis. Respir Res. 2011;12:111.CrossRefPubMedPubMedCentral
5.
go back to reference Kusagaya H, Nakamura Y, Kono M, Kaida Y, Kuroishi S, Enomoto N, et al. Idiopathic pleuroparenchymal fibroelastosis: consideration of a clinicopathological entity in a series of Japanese patients. BMC Pulm Med. 2012;12:72.CrossRefPubMedPubMedCentral Kusagaya H, Nakamura Y, Kono M, Kaida Y, Kuroishi S, Enomoto N, et al. Idiopathic pleuroparenchymal fibroelastosis: consideration of a clinicopathological entity in a series of Japanese patients. BMC Pulm Med. 2012;12:72.CrossRefPubMedPubMedCentral
6.
go back to reference Watanabe K, Nagata N, Kitasato Y, Wakamatsu K, Nabeshima K, Harada T, et al. Rapid decrease in forced vital capacity in patients with idiopathic pulmonary upper lobe fibrosis. Respir Investig. 2012;50(3):88–97.CrossRefPubMed Watanabe K, Nagata N, Kitasato Y, Wakamatsu K, Nabeshima K, Harada T, et al. Rapid decrease in forced vital capacity in patients with idiopathic pulmonary upper lobe fibrosis. Respir Investig. 2012;50(3):88–97.CrossRefPubMed
7.
8.
go back to reference Oda T, Ogura T, Kitamura H, Hagiwara E, Baba T, Enomoto Y, et al. Distinct characteristics of pleuroparenchymal fibroelastosis with usual interstitial pneumonia compared with idiopathic pulmonary fibrosis. Chest. 2014;146(5):1248–55.CrossRefPubMed Oda T, Ogura T, Kitamura H, Hagiwara E, Baba T, Enomoto Y, et al. Distinct characteristics of pleuroparenchymal fibroelastosis with usual interstitial pneumonia compared with idiopathic pulmonary fibrosis. Chest. 2014;146(5):1248–55.CrossRefPubMed
9.
go back to reference Nakatani T, Arai T, Kitaichi M, Akira M, Tachibana K, Sugimoto C, et al. Pleuroparenchymal fibroelastosis from a consecutive database: a rare disease entity? Eur Respir J. 2015;45(4):1183–6.CrossRefPubMed Nakatani T, Arai T, Kitaichi M, Akira M, Tachibana K, Sugimoto C, et al. Pleuroparenchymal fibroelastosis from a consecutive database: a rare disease entity? Eur Respir J. 2015;45(4):1183–6.CrossRefPubMed
10.
go back to reference Yoshida Y, Nagata N, Tsuruta N, Kitasato Y, Wakamatsu K, Yoshimi M, et al. Heterogeneous clinical features in patients with pulmonary fibrosis showing histology of pleuroparenchymal fibroelastosis. Respir Investig. 2016;54(3):162–9.CrossRefPubMed Yoshida Y, Nagata N, Tsuruta N, Kitasato Y, Wakamatsu K, Yoshimi M, et al. Heterogeneous clinical features in patients with pulmonary fibrosis showing histology of pleuroparenchymal fibroelastosis. Respir Investig. 2016;54(3):162–9.CrossRefPubMed
11.
go back to reference Cheng SKH, Chuah KL. Pleuroparenchymal fibroelastosis of the lung: a review. Arch Pathol Lab Med. 2016;140(8):849–53.CrossRefPubMed Cheng SKH, Chuah KL. Pleuroparenchymal fibroelastosis of the lung: a review. Arch Pathol Lab Med. 2016;140(8):849–53.CrossRefPubMed
12.
go back to reference Yousem SA. Pulmonary apical cap: a distinctive but poorly recognized lesion in pulmonary surgical pathology. The American journal of surgical pathology. 2001;25(5):679–83.CrossRefPubMed Yousem SA. Pulmonary apical cap: a distinctive but poorly recognized lesion in pulmonary surgical pathology. The American journal of surgical pathology. 2001;25(5):679–83.CrossRefPubMed
13.
go back to reference Lagstein A. Pulmonary apical cap-what’s old is new again. Arch Pathol Lab Med. 2015;139(10):1258–62.CrossRefPubMed Lagstein A. Pulmonary apical cap-what’s old is new again. Arch Pathol Lab Med. 2015;139(10):1258–62.CrossRefPubMed
14.
go back to reference McLoud TC, Isler RJ, Novelline RA, Putman CE, Simeone J, Stark P. The apical cap. AJR Am J Roentgenol. 1981;137(2):299–306.CrossRefPubMed McLoud TC, Isler RJ, Novelline RA, Putman CE, Simeone J, Stark P. The apical cap. AJR Am J Roentgenol. 1981;137(2):299–306.CrossRefPubMed
15.
go back to reference Im JG, Webb WR, Han MC, Park JH. Apical opacity associated with pulmonary tuberculosis: high-resolution CT findings. Radiology. 1991;178(3):727–31.CrossRefPubMed Im JG, Webb WR, Han MC, Park JH. Apical opacity associated with pulmonary tuberculosis: high-resolution CT findings. Radiology. 1991;178(3):727–31.CrossRefPubMed
16.
go back to reference Reddy TL, Tominaga M, Hansell DM, von der Thusen J, Rassl D, Parfrey H, et al. Pleuroparenchymal fibroelastosis: a spectrum of histopathological and imaging phenotypes. Eur Respir. 2012;40(2):377–85.CrossRef Reddy TL, Tominaga M, Hansell DM, von der Thusen J, Rassl D, Parfrey H, et al. Pleuroparenchymal fibroelastosis: a spectrum of histopathological and imaging phenotypes. Eur Respir. 2012;40(2):377–85.CrossRef
19.
go back to reference Kokosi MA, Nicholson AG, Hansell DM, Wells AU. Rare idiopathic interstitial pneumonias: LIP and PPFE and rare histologic patterns of interstitial pneumonias: AFOP and BPIP. Respirology (Carlton, Vic). 2016;21(4):600–14.CrossRef Kokosi MA, Nicholson AG, Hansell DM, Wells AU. Rare idiopathic interstitial pneumonias: LIP and PPFE and rare histologic patterns of interstitial pneumonias: AFOP and BPIP. Respirology (Carlton, Vic). 2016;21(4):600–14.CrossRef
20.
go back to reference Enomoto Y, Nakamura Y, Colby TV, Johkoh T, Sumikawa H, Nishimoto K, et al. Radiologic pleuroparenchymal fibroelastosis-like lesion in connective tissue disease-related interstitial lung disease. PLoS One. 2017;12(6):e0180283.CrossRefPubMedPubMedCentral Enomoto Y, Nakamura Y, Colby TV, Johkoh T, Sumikawa H, Nishimoto K, et al. Radiologic pleuroparenchymal fibroelastosis-like lesion in connective tissue disease-related interstitial lung disease. PLoS One. 2017;12(6):e0180283.CrossRefPubMedPubMedCentral
Metadata
Title
Pleuroparenchymal fibroelastosis-like lesions on chest computed tomography in routine clinical practice
Authors
Hiromitsu Sumikawa
Takeshi Johkoh
Tae Iwasawa
Katsuyuki Nakanishi
Noriyuki Tomiyama
Publication date
01-03-2019
Publisher
Springer Japan
Published in
Japanese Journal of Radiology / Issue 3/2019
Print ISSN: 1867-1071
Electronic ISSN: 1867-108X
DOI
https://doi.org/10.1007/s11604-018-0805-5

Other articles of this Issue 3/2019

Japanese Journal of Radiology 3/2019 Go to the issue