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Non-specific interstitial pneumonia in cigarette smokers: a CT study.

Marten K, Milne D, Antoniou KM, Nicholson AG, Tennant RC, Hansel TT, Wells AU, Hansell DM - Eur Radiol (2009)

Bottom Line: Prevalence and extent of emphysema in 18 smokers with NSIP were compared with subjects meeting GOLD criteria for chronic obstructive pulmonary disease (COPD; group A; n = 34) and healthy smokers (normal FEV(1); group B; n = 103), respectively.On multiple logistic regression, the likelihood of emphysema increased when NSIP was present (OR = 18.8; 95% CI = 5.3-66.3; P < 0.0005) and with increasing age (OR = 1.04; 95% CI = 0.99-1.11; P = 0.08).Emphysema is as prevalent in smokers with NSIP as in smokers with COPD, and is strikingly more prevalent in these two groups than in healthy smoking controls.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Georg August University of Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Germany. kmarten@med.uni-goettingen.de

ABSTRACT
The goal of this study was to seek indirect evidence that smoking is an aetiological factor in some patients with non-specific interstitial pneumonia (NSIP). Ten current and eight ex-smokers with NSIP were compared to controls including 137 current smokers with no known interstitial lung disease and 11 non-smokers with NSIP. Prevalence and extent of emphysema in 18 smokers with NSIP were compared with subjects meeting GOLD criteria for chronic obstructive pulmonary disease (COPD; group A; n = 34) and healthy smokers (normal FEV(1); group B; n = 103), respectively. Emphysema was present in 14/18 (77.8%) smokers with NSIP. Emphysema did not differ in prevalence between NSIP patients and group A controls (25/34, 73.5%), but was strikingly more prevalent in NSIP patients than in group B controls (18/103, 17.5%, P < 0.0005). On multiple logistic regression, the likelihood of emphysema increased when NSIP was present (OR = 18.8; 95% CI = 5.3-66.3; P < 0.0005) and with increasing age (OR = 1.04; 95% CI = 0.99-1.11; P = 0.08). Emphysema is as prevalent in smokers with NSIP as in smokers with COPD, and is strikingly more prevalent in these two groups than in healthy smoking controls. The association between NSIP and emphysema provides indirect support for a smoking pathogenesis hypothesis in some NSIP patients.

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Related in: MedlinePlus

Thin-section CT of a 44-year-old female non-smoker with NSIP showing widespread diffuse ground-glass opacification with some thickening of the interlobular septa (crazy-paving pattern). Total extent of interstitial disease was scored as 35% (40% assigned as ground-glass opacification without traction bronchiectasis and 60% as crazy-paving pattern)
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Fig1: Thin-section CT of a 44-year-old female non-smoker with NSIP showing widespread diffuse ground-glass opacification with some thickening of the interlobular septa (crazy-paving pattern). Total extent of interstitial disease was scored as 35% (40% assigned as ground-glass opacification without traction bronchiectasis and 60% as crazy-paving pattern)

Mentions: In NSIP patients and smoking controls, the presence or absence of emphysema was recorded; disagreement was resolved by consensus. Subsequently, in NSIP patients, the five CT sections were scored to the nearest 5% for the extent of lung with interstitial disease. An estimation was made to the nearest 5% (summing to 100%) of the contribution made by individual patterns as defined in the Fleischner Society glossary [8] (ground-glass opacification with traction bronchiectasis, pure ground-glass opacification, honeycombing, a reticular pattern not otherwise specified, nodules, lobules of decreased attenuation likely to represent air-trapping, a pattern resembling the appearance of pulmonary Langerhans cell histiocytosis, “crazy paving” pattern and consolidation). The extents of individual patterns (examples shown in Figs. 1, 2 and 3) were derived, and the mean values for the two observers were analysed.Fig. 1


Non-specific interstitial pneumonia in cigarette smokers: a CT study.

Marten K, Milne D, Antoniou KM, Nicholson AG, Tennant RC, Hansel TT, Wells AU, Hansell DM - Eur Radiol (2009)

Thin-section CT of a 44-year-old female non-smoker with NSIP showing widespread diffuse ground-glass opacification with some thickening of the interlobular septa (crazy-paving pattern). Total extent of interstitial disease was scored as 35% (40% assigned as ground-glass opacification without traction bronchiectasis and 60% as crazy-paving pattern)
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2691530&req=5

Fig1: Thin-section CT of a 44-year-old female non-smoker with NSIP showing widespread diffuse ground-glass opacification with some thickening of the interlobular septa (crazy-paving pattern). Total extent of interstitial disease was scored as 35% (40% assigned as ground-glass opacification without traction bronchiectasis and 60% as crazy-paving pattern)
Mentions: In NSIP patients and smoking controls, the presence or absence of emphysema was recorded; disagreement was resolved by consensus. Subsequently, in NSIP patients, the five CT sections were scored to the nearest 5% for the extent of lung with interstitial disease. An estimation was made to the nearest 5% (summing to 100%) of the contribution made by individual patterns as defined in the Fleischner Society glossary [8] (ground-glass opacification with traction bronchiectasis, pure ground-glass opacification, honeycombing, a reticular pattern not otherwise specified, nodules, lobules of decreased attenuation likely to represent air-trapping, a pattern resembling the appearance of pulmonary Langerhans cell histiocytosis, “crazy paving” pattern and consolidation). The extents of individual patterns (examples shown in Figs. 1, 2 and 3) were derived, and the mean values for the two observers were analysed.Fig. 1

Bottom Line: Prevalence and extent of emphysema in 18 smokers with NSIP were compared with subjects meeting GOLD criteria for chronic obstructive pulmonary disease (COPD; group A; n = 34) and healthy smokers (normal FEV(1); group B; n = 103), respectively.On multiple logistic regression, the likelihood of emphysema increased when NSIP was present (OR = 18.8; 95% CI = 5.3-66.3; P < 0.0005) and with increasing age (OR = 1.04; 95% CI = 0.99-1.11; P = 0.08).Emphysema is as prevalent in smokers with NSIP as in smokers with COPD, and is strikingly more prevalent in these two groups than in healthy smoking controls.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Georg August University of Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Germany. kmarten@med.uni-goettingen.de

ABSTRACT
The goal of this study was to seek indirect evidence that smoking is an aetiological factor in some patients with non-specific interstitial pneumonia (NSIP). Ten current and eight ex-smokers with NSIP were compared to controls including 137 current smokers with no known interstitial lung disease and 11 non-smokers with NSIP. Prevalence and extent of emphysema in 18 smokers with NSIP were compared with subjects meeting GOLD criteria for chronic obstructive pulmonary disease (COPD; group A; n = 34) and healthy smokers (normal FEV(1); group B; n = 103), respectively. Emphysema was present in 14/18 (77.8%) smokers with NSIP. Emphysema did not differ in prevalence between NSIP patients and group A controls (25/34, 73.5%), but was strikingly more prevalent in NSIP patients than in group B controls (18/103, 17.5%, P < 0.0005). On multiple logistic regression, the likelihood of emphysema increased when NSIP was present (OR = 18.8; 95% CI = 5.3-66.3; P < 0.0005) and with increasing age (OR = 1.04; 95% CI = 0.99-1.11; P = 0.08). Emphysema is as prevalent in smokers with NSIP as in smokers with COPD, and is strikingly more prevalent in these two groups than in healthy smoking controls. The association between NSIP and emphysema provides indirect support for a smoking pathogenesis hypothesis in some NSIP patients.

Show MeSH
Related in: MedlinePlus