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Improvement in idiopathic nonspecific interstitial pneumonia after smoking cessation.

Shinohara T, Kadota N, Hino H, Naruse K, Ohtsuki Y, Ogushi F - Respir Med Case Rep (2014)

Bottom Line: Although cigarette smoking has been recognized as a risk factor for the development of several interstitial lung diseases, the relationship between smoking and nonspecific interstitial pneumonia (NSIP) has not yet been fully elucidated.We here present a case of fibrotic NSIP with mild emphysema in an elderly male with normal pulmonary function, whose symptoms, serum KL-6 level, and high-resolution computed tomography findings of interstitial changes markedly improved without medication following the cessation of smoking.Our case suggests that smoking may be an etiological factor in some patients with NSIP and that early smoking cessation before a clinically detectable decline in pulmonary function may be critical for smokers with idiopathic NSIP.

View Article: PubMed Central - PubMed

Affiliation: Department of Clinical Investigation, National Hospital Organization National Kochi Hospital, 1-2-25 Asakuranishimachi, Kochi 780-8077, Japan.

ABSTRACT
Although cigarette smoking has been recognized as a risk factor for the development of several interstitial lung diseases, the relationship between smoking and nonspecific interstitial pneumonia (NSIP) has not yet been fully elucidated. We here present a case of fibrotic NSIP with mild emphysema in an elderly male with normal pulmonary function, whose symptoms, serum KL-6 level, and high-resolution computed tomography findings of interstitial changes markedly improved without medication following the cessation of smoking. Our case suggests that smoking may be an etiological factor in some patients with NSIP and that early smoking cessation before a clinically detectable decline in pulmonary function may be critical for smokers with idiopathic NSIP.

No MeSH data available.


Related in: MedlinePlus

HRCT images (a-b, before surgical biopsy: f, 4 months after the cessation of smoking) and pathological findings (c-e). (a) the upper zones of the lungs showing paraseptal and centrilobular emphysema. (b) the lower zones of the lungs showing ground-glass opacity and reticular patterns. (c) irregular interstitial fibrosis with mild chronic inflammation. (d) emphysema in the non-fibrotic lesion. (e) intraluminal accumulation of macrophages. (f) marked improvements in ground-glass opacity and reticular patterns.
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fig1: HRCT images (a-b, before surgical biopsy: f, 4 months after the cessation of smoking) and pathological findings (c-e). (a) the upper zones of the lungs showing paraseptal and centrilobular emphysema. (b) the lower zones of the lungs showing ground-glass opacity and reticular patterns. (c) irregular interstitial fibrosis with mild chronic inflammation. (d) emphysema in the non-fibrotic lesion. (e) intraluminal accumulation of macrophages. (f) marked improvements in ground-glass opacity and reticular patterns.

Mentions: Chest X-ray showed no obvious abnormal findings; however, HRCT demonstrated mild emphysema in the upper lung fields (Fig. 1a). HRCT also revealed ground-glass opacity and reticular patterns without honeycombing in the lower lung fields, which were consistent with an NSIP pattern. A crazy-paving pattern, which was previously reported to be frequent in non-smokers with NSIP [3], was not observed (Fig. 1b).


Improvement in idiopathic nonspecific interstitial pneumonia after smoking cessation.

Shinohara T, Kadota N, Hino H, Naruse K, Ohtsuki Y, Ogushi F - Respir Med Case Rep (2014)

HRCT images (a-b, before surgical biopsy: f, 4 months after the cessation of smoking) and pathological findings (c-e). (a) the upper zones of the lungs showing paraseptal and centrilobular emphysema. (b) the lower zones of the lungs showing ground-glass opacity and reticular patterns. (c) irregular interstitial fibrosis with mild chronic inflammation. (d) emphysema in the non-fibrotic lesion. (e) intraluminal accumulation of macrophages. (f) marked improvements in ground-glass opacity and reticular patterns.
© Copyright Policy - CC BY-NC-ND
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4356029&req=5

fig1: HRCT images (a-b, before surgical biopsy: f, 4 months after the cessation of smoking) and pathological findings (c-e). (a) the upper zones of the lungs showing paraseptal and centrilobular emphysema. (b) the lower zones of the lungs showing ground-glass opacity and reticular patterns. (c) irregular interstitial fibrosis with mild chronic inflammation. (d) emphysema in the non-fibrotic lesion. (e) intraluminal accumulation of macrophages. (f) marked improvements in ground-glass opacity and reticular patterns.
Mentions: Chest X-ray showed no obvious abnormal findings; however, HRCT demonstrated mild emphysema in the upper lung fields (Fig. 1a). HRCT also revealed ground-glass opacity and reticular patterns without honeycombing in the lower lung fields, which were consistent with an NSIP pattern. A crazy-paving pattern, which was previously reported to be frequent in non-smokers with NSIP [3], was not observed (Fig. 1b).

Bottom Line: Although cigarette smoking has been recognized as a risk factor for the development of several interstitial lung diseases, the relationship between smoking and nonspecific interstitial pneumonia (NSIP) has not yet been fully elucidated.We here present a case of fibrotic NSIP with mild emphysema in an elderly male with normal pulmonary function, whose symptoms, serum KL-6 level, and high-resolution computed tomography findings of interstitial changes markedly improved without medication following the cessation of smoking.Our case suggests that smoking may be an etiological factor in some patients with NSIP and that early smoking cessation before a clinically detectable decline in pulmonary function may be critical for smokers with idiopathic NSIP.

View Article: PubMed Central - PubMed

Affiliation: Department of Clinical Investigation, National Hospital Organization National Kochi Hospital, 1-2-25 Asakuranishimachi, Kochi 780-8077, Japan.

ABSTRACT
Although cigarette smoking has been recognized as a risk factor for the development of several interstitial lung diseases, the relationship between smoking and nonspecific interstitial pneumonia (NSIP) has not yet been fully elucidated. We here present a case of fibrotic NSIP with mild emphysema in an elderly male with normal pulmonary function, whose symptoms, serum KL-6 level, and high-resolution computed tomography findings of interstitial changes markedly improved without medication following the cessation of smoking. Our case suggests that smoking may be an etiological factor in some patients with NSIP and that early smoking cessation before a clinically detectable decline in pulmonary function may be critical for smokers with idiopathic NSIP.

No MeSH data available.


Related in: MedlinePlus