|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| |
ABSTRACT |
|---|
|
|
|---|
Findings of surgical lung biopsy (SLB) are important in categorizing patients with idiopathic interstitial pneumonia (IIP). We investigated whether histologic variability would be evident in SLB specimens from multiple lobes in patients with IIP. SLBs from 168 patients, 109 of whom had multiple lobes biopsied, were reviewed by three pathologists. A diagnosis was assigned to each lobe. A different diagnosis was found between lobes in 26% of the patients. Patients with usual interstitial pneumonia (UIP) in all lobes were categorized as concordant for UIP (n = 51) and those with UIP in at least one lobe were categorized as discordant for UIP (n = 28). Patients with nonspecific interstitial pneumonia (NSIP) in all lobes were categorized as having fibrotic (n = 25) or cellular NSIP (n = 5). No consistent distribution of lobar histology was noted. Patients concordant for UIP were older (63 ± 9 [mean ± SD] yr; p < 0.05 as compared with all other groups) than those discordant for UIP (57 ± 12 yr) or with fibrotic NSIP (56 ± 11 yr) or cellular NSIP (50 ± 9 yr). Semiquantitative high-resolution computed tomography demonstrated a varied profusion of fibrosis (p < 0.05 for all group comparisons), with more fibrosis in concordant UIP (2.13 ± 0.62) than in discordant UIP (1.42 ± 0.73), fibrotic NSIP (0.83 ± 0.58), or cellular NSIP (0.44 ± 0.42). Survival was better for patients with NSIP than for those in both UIP groups (p < 0.001), although survival in the two UIP groups was comparable (p = 0.16). Lobar histologic variability is frequent in patients with IIP, patients with a histologic pattern of UIP in any lobe should be classified as having UIP.
| |
INTRODUCTION |
|---|
|
|
|---|
Keywords: pulmonary fibrosis; usual interstitial pneumonia; nonspecific interstitial pneumonia; idiopathic interstitial pneumonia; idiopathic pulmonary fibrosis
Patients with nonspecific interstitial pneumonia (NSIP) have better survival than those with usual interstitial pneumonia (UIP) (1). In addition, patients with a predominantly cellular pattern of NSIP appear to have a better prognosis than those with either UIP or a fibrotic pattern of NSIP (3). The ability of histopathology to predict prognosis has generated renewed interest in categorizing patients with idiopathic interstitial pneumonia (IIP) according to histology (6, 7).
Recently, an American Thoracic Society (ATS) statement concluded that idiopathic pulmonary fibrosis (IPF) should reflect only the histologic picture of UIP, thus making patients with IPF a more homogeneous group with a worse prognosis than previously described (8). However, the current literature indicates some differences in survival of patients with NSIP (and especially fibrotic NSIP) among several series (3, 9), suggesting that diagnostic criteria for NSIP may not be uniformly applied. This is not surprising, since NSIP includes a spectrum of inflammatory and fibrosing lesions that do not fall within the histologic criteria for UIP, and as such, it represents somewhat of a "wastebasket" condition (3). A consensus on diagnostic criteria for NSIP remains to be established, and the relationship between the cellular and fibrosing patterns of NSIP and UIP needs further study.
High-resolution computed tomography (HRCT) scans in patients with IIP are heterogeneous; the typical changes in UIP are first noted at the bases of the lungs (10). We hypothesized that there would also be significant histologic variability in the surgical lung biopsies (SLB) of patients with IIP when they were examined at the lobar level. The purpose of this study was to evaluate intrapatient lobar variability in patients with IIP and to determine how to classify patients when lobar variability was present.
| |
METHODS |
|---|
|
|
|---|
Patient Recruitment and Therapy
The study utilized patients in the data base of the University of Michigan Specialized Center of Research (SCOR) in the Pathobiology of Fibrotic Lung Disease. Patients in this data base were referred for enrollment in study protocols for suspected interstitial pulmonary fibrosis (IPF) and underwent SLB between October 1989 and February 2000. In these patients, a suspicion of IPF was based on symptoms, physiologic abnormalities, and radiographic findings. None of the patients had undergone previous SLB or received therapy for IPF. Patients without a histopathologic pattern of NSIP or UIP were excluded from this analysis (respiratory bronchiolitis interstitial lung disease/desquamative interstitial pneumonitis, n = 22; bronchiolitis obliterans organizing pneumonia, n = 1; hypersensitivity pneumonia, n = 5; and unclassified, n = 1). We also excluded 27 patients with UIP and three patients with NSIP who did not have a biopsy specimen from more than one lobe. Patients were additionally excluded if they were found to have a disease other than IPF during the enrollment evaluation. Diseases that were exclusionary included pneumoconiosis, sarcoidosis, cancer, lymphoma, Langerhan's histiocytosis, and lymphangioleiomyomatosis. Similarly, patients with underlying collagen vascular disease were excluded from analysis. Patients were treated with a variety of regimens (Table 1). Clinical information has been reported (11, 12) on a subgroup (n = 26) of these patients categorized as having IPF according to previously published criteria (13). Five of these patients (19%) were reclassified using criteria described in the section on pathologic assessment.
|
Biopsy Technique
All patients in the study underwent SLB by formal thoracotomy or video-assisted thoracoscopy. Similar sized biopsy specimens were obtained by either technique. All patients had an SLB involving more than one lobe. Surgeons were asked to obtain biopsy specimens from all three lobes on the right side or from the upper and lower lobes on the left side, with exclusion of the lingula.
Pathologic Assessment
All biopsy slides available for review were obtained, and each lobe was assigned a random number and reviewed by three pathologists (T.V.C., A.F., W.D.T.). Initial readings were done individually without knowledge of other pathologists' interpretations or any clinical or radiographic information. Cases without a uniform diagnostic consensus among the three examining pathologists' were reviewed by all three together to reach a consensus during three review sessions between March 1999 and February 2000. The pathologists assigned a diagnosis of UIP, NSIP, or "other" to each lobe. Patients with NSIP were further classified as having predominantly cellular or fibrosing patterns according to established criteria (3, 9). The definition of NSIP was still evolving at the beginning of the study; all specimens classified as representing NSIP were re-reviewed at the end of the study period (February 2000) for consistency and to confirm the accuracy of the initial diagnosis. UIP was defined by patchy dense interstitial fibrosis, often with a subpleural and paraseptal distribution and associated with loss of lung architecture, frequent honeycomb changes, and fibroblastic foci (9). Interstitial inflammation was usually minimal. Fibrotic NSIP was defined by dense or loose interstitial fibrosis lacking the temporal heterogeneity of UIP and usually showing diffuse uniform involvement of the lung tissue (spatial uniformity). Fibroblastic foci were inconspicuous or absent, and inflammation was mild to moderate. Cellular NSIP was characterized by mild to moderate chronic interstitial inflammation without interstitial fibrosis. Type II pneumocyte hyperplasia was often present in areas of inflammation. Foci of organizing pneumonia could be seen in both NSIP groups, but these were focal and not the predominant feature. Cellular NSIP corresponded to group 1 of Katzenstein and Fiorelli, whereas fibrotic NSIP corresponded to Katzenstein and Fiorelli groups 2 and 3 (6). Cases were classified in the following manner to allow comparison of demographic data, pulmonary physiology, radiographic data, and survival:
1. Concordant UIP: UIP pattern in all lobes.
2. Discordant UIP: UIP pattern in at least one lobe but a non-UIP pattern in at least one lobe (intrapatient lobar variability).
3. Fibrotic NSIP: Fibrotic NSIP pattern in all lobes or a combination of a fibrotic NSIP and cellular NSIP pattern.
4. Cellular NSIP: Cellular NSIP pattern in all lobes.
Physiologic Assessment
Physiologic assessment was performed before SLB and before the initiation of therapy. Pulmonary function tests including spirometry, lung volume measurements, and diffusion capacity for carbon monoxide (DLCO) were done on the same day and before a cardiopulmonary exercise test (CPET) as previously described (12).
HRCT Protocol
HRCT examinations were performed with 1.0- or 1.5-mm-thick sections taken at 1-cm intervals throughout the lungs during inspiration with the patient in the supine position, and through the caudal 10 cm of the lungs at 2- to 3-cm increments with the patient in the prone position. All HRCT scans were done from 1 to 4 wk before SLB. Two thoracic radiologists (E.A.K., B.H.G.) prospectively and independently scored all lobes on HRCT for ground-glass opacity (CT-alv) and interstitial opacity (CT-fib) on a scale of 0 to 5 as described previously (14). The radiologists were unaware of the histologic diagnosis at the time of interpretation.
Statistical Analysis
Categorical data for the various histopathologic groups were compared through the use of Fisher's exact test, and continuous data were compared through analysis of variance (ANOVA). When ANOVA results indicated that histopathologic groups differed, post hoc comparisons were performed on the relevant continuous measures with unpaired, two-tailed t tests. All t tests assumed unequal variances, and a value of p < 0.05 was considered statistically significant. Survival experiences for histopathologic groups were illustrated via Kaplan- Meier curves. Cox regression analysis was used to examine the relationship between histopathologic group and mortality, with control for demographic characteristics such as age, sex, and smoking status, and baseline physiologic and radiographic variables. NSIP patients were grouped together for survival analysis, since there were no deaths among the patients with cellular NSIP.
| |
RESULTS |
|---|
|
|
|---|
Patient Population
One hundred and sixty-eight patients had an SLB during the study period. One hundred and nine had biopsies in multiple lobes and were included in the study. The baseline characteristics for these patients are shown in Table 2.
|
Lobar Histologic Variability
Significant intrapatient variability was noted. The lobar distribution of UIP and NSIP is shown in Figure 1. Fifty-one patients exhibited a histologic picture of UIP in all lobes evaluated (concordant UIP); 28 patients had NSIP in at least one lobe and UIP in at least one lobe (discordant UIP). The NSIP pattern was fibrotic in 92% of the lobes and cellular in 8%. Twenty-eight patients had NSIP in all lobes sampled. There was no predilection for the distribution of UIP or NSIP by location of lobe when this was examined both for all patients (Figure 1a; chi-square p = 0.14) and for patients with discordant UIP (Figure 1b; chi-square p = 0.20). In 11 patients, two or more biopsies were taken from the same lobe; discordant histology was noted in eight of these patients. The pathologists' individual histologic interpretations agreed in 66.9% of the lobes biopsied.
|
Baseline Characteristics
Patients' baseline demographic, physiologic, and HRCT characteristics are shown in Table 2. Age differed among the study groups and tended to increase as the number of lobes with UIP increased. No significant differences were noted in the gender distribution, duration of symptoms, or smoking status of the groups. Differences in TLC % predicted were present, although a uniform trend for these differences did not exist across histologic categories.
Differences were also noted in HRCT features (Table 2). Although patients concordant for UIP demonstrated greater ground glass opacity than patients with fibrotic NSIP, the greatest differences were noted in interstitial abnormality as shown by HRCT. Patients concordant for UIP demonstrated a greater profusion of abnormality than all other groups. Patients discordant for UIP were of intermediate status, with greater abnormality than both NSIP groups, and patients with fibrotic NSIP had higher scores than patients with cellular NSIP.
Survival
Marked differences in survival were noted among the different histologic groups (Figure 2). Patients with NSIP had better survival than did either UIP group. This NSIP advantage persisted even after age, gender, smoking history, physiologic variables, and onset of symptoms were controlled. The risk of mortality was 24.3 times greater (95% confidence interval [CI]: 3.3 to 177; p <0.0001) for patients concordant for UIP than for those with NSIP. The risk of mortality was 16.8 times greater (95% CI: 2.8 to 98.9; p < 0.0001) for patients discordant for UIP than for NSIP patients. Survival of patients concordant for UIP as compared with that of patients discordant for UIP was similar when either the early portion of the survival curve was weighted (Wilcoxon's test p value = 0.16) or when equal statistical weight was given to each time point (log rank test, p = 0.16). The survival experience of the NSIP groups was statistically similar (log rank test, p = 0.33); the sample size yielded a 79.7% power in this analysis.
|
| |
DISCUSSION |
|---|
|
|
|---|
Radiographic findings in patients with IIP demonstrated lobar heterogeneity. We hypothesized that heterogeneity of histologic diagnosis might exist from lobe to lobe in SLB specimens from patients with suspected IIP. Our findings showed that: (1) interlobar and intralobar histologic variability is present in IIP; and (2) the presence of a UIP pattern in any sample confers a poor prognosis. These data quantify the frequency of histologic variability in IIP and suggest a paradigm for assigning a histologic diagnosis if histologic heterogeneity is identified.
Interlobar histologic variability is common in IIP. This complicates the histologic classification of the disease. The histologic classification in 26% of the patients in our study could have differed between UIP and NSIP if only one biopsy had been obtained. Histologic heterogeneity has received little attention in the literature (13, 15, 16). No previous studies have analyzed the frequency of coexistence of histologic patterns suggestive of NSIP and UIP in the same patient. Heterogeneity of histologic patterns among lobes documents that significant sampling errors may result from protocols that obtain only one biopsy specimen for IIP. Our findings emphasize the value of obtaining a biopsy specimen from multiple lobes during a diagnostic evaluation for IIP.
A histologic pattern of UIP in any lobe, even if a pattern of NSIP is seen in other lobes, is associated with a poor prognosis. We propose that these patients be classified as having UIP. This proposal is based largely on our finding that UIP-concordant and UIP-discordant patients had similar relative risks of mortality, and that the mortality of each of these groups was poor as compared with that for patients with NSIP. Differences in baseline demographic and physiologic characteristics were small and not of sufficient magnitude to allow the clinical separation of groups. Conversely, the amount of fibrosis seen on HRCT differed in all groups, being greatest in the group with concordant UIP and successively less so in the groups with discordant UIP, fibrotic NSIP, and cellular NSIP, in that order. Further investigation is needed to see if the degree of fibrosis seen on HRCT can serve as a surrogate marker for the presence of UIP in patients unable to undergo SLB.
The finding of patterns of UIP and NSIP within the same patient raises questions about the pathogenesis and nosology of these disorders. Several pathogenic sequences are possible. NSIP may be an early lesion that progresses with time to UIP. Our patients with NSIP were younger than our patients with discordant UIP, who in turn were younger than our patients with concordant UIP. Similar differences were observed for the degree of fibrosis seen on HRCT. Interestingly, patients with cellular NSIP and those concordant for UIP had less extensive ground glass infiltrates on HRCT than did patients with fibrotic NSIP and those discordant for UIP. Some have speculated that ground glass infiltrates may represent areas of inflammation or fine fibrosis (10). If this is true, our data could support the hypothesis that inflammation/fine fibrosis is early and mild in cellular NSIP and increases with fibrotic NSIP and discordant UIP, only to be "burnt out" with concordant UIP. These data could be interpreted to support the concept of an evolving disease process from NSIP to UIP, with gradually increasing physiologic derangement and fibrosis, and eventual death. Our data do not address whether this continuum should include all NSIP or only fibrotic NSIP. Our data and those of others suggest that cellular NSIP and fibrotic NSIP may not necessarily be related (3, 5). However, these cross-sectional data are not conclusive, particularly since the histologic pattern of NSIP is predominantly diffuse, whereas that of UIP is patchier. Because the characterization of NSIP remains a "work in progress," further prospective evaluation of the change in pulmonary function, as well as sequential quantitative and qualitative HRCT studies with the passage of time, are required.
The current prevailing concept is that fibrotic NSIP can lead to fibrosis and death (17) while representing a different disease process than UIP (personal communication from W. Travis, co-chair of ATS/European Respiratory Society [ERS] International Multidisciplinary Consensus Classification of Idiopathic Interstitial Pneumonias committee). This important issue can best be addressed by a longitudinal study design. Studies of patients that compare biopsy findings on SLB at the time of initial diagnosis of IIP with findings subsequently obtained from lung tissue removed at lung transplantation or autopsy could be instructive. Serial HRCT scanning may offer an alternative method to serial biopsy for monitoring changes in the degree of fibrosis over time. Although previous studies suggested specific HRCT findings in patients with NSIP (18, 19), more recent data highlight the limitation of these radiographic findings in accurate diagnosis (20, 21). Interestingly, short-term studies of serial HRCT scans have suggested improvement in NSIP patients (22, 23), in contrast to those with UIP (24). Further prospective data collection is required to answer this important question.
Our data provide valuable evidence on which to base recommendations for diagnostic SLB in patients suspected of having IIP. The biopsy technique should maximize the likelihood of identifying the histologic pattern of UIP. Adoption of this practice would result in more accurate segregation of patients into those with UIP and those with NSIP. Given the poor prognosis associated with a UIP pattern on any biopsy, the most important goal of the biopsy is finding UIP. Biopsy specimens should be obtained from areas that reflect the entire gamut of gross disease patterns as guided by intraoperative inspection of the lung surface or correlation with HRCT abnormality. This may be achieved by HRCT-guided biopsies or biopsies of multiple lung zones. Areas of gross honeycombing should be avoided, since they show end stage disease, and areas that show intermediate or relatively preserved lung should specifically be selected for biopsy, since the lung specimen must have fibrotic lung adjacent to normal lung for the pathologist to identify the UIP pattern. Our data support the concept that biopsy should be performed in a fashion that minimizes the chance of failing to sample areas most likely to demonstrate the histologic picture of UIP. Missing an area of NSIP when UIP is present will have less clinical impact (in terms of an accurate prognosis) than will missing UIP when UIP is actually present.
The results of this study emphasize the importance of the pathologic findings obtained on SLB. The distinctions between pathologic diagnoses and clinical diagnoses were addressed by an international multidisciplinary ATS/ERS panel for the classification of IIPs (personal communication, W. Travis, co-chair of the ATS/ERS International Multidisciplinary Consensus Classification of Idiopathic Interstitial Pneumonias committee). In our series, the appropriate histopathologic diagnosis was straightforward for those patients with a pathologic pattern of NSIP or UIP in all multiple biopsy specimens. However, there was some question about how patients should be classified if multiple biopsies showed different patterns. Our data suggest that presence of the UIP pattern is the most important factor in predicting clinical outcome, and that patients should be classified as having UIP even if their lung histology is discordant. Nevertheless, the clinical differences we observed suggest that patients discordant for UIP have some intermediate features that fall between concordant UIP and NSIP.
The long-term, prospective follow-up of patients with NSIP is required to determine whether their survival declines with time, as recently suggested (5). A decrease in survival with time would suggest that patients with NSIP have disease that is evolving into UIP, and that their improved survival reflects lead-time bias. This information, however, will not be definitive. Clearly, further prospective data collection and consensus on the histologic pattern of NSIP are required to address these important questions. Studies of the expression of effector molecules and/or receptors may provide additional powerful diagnostic surrogates for putative subtypes of IIP. An understanding of the alveolar microenvironment in patients with IIP is crucial to the development of new, meaningful therapeutic interventions for this disease.
| |
Footnotes |
|---|
Correspondence and requests for reprints should be addressed to Fernando J. Martinez, M.D., 1500 E. Medical Center Dr., 3916 TC, Ann Arbor, MI 48109-0360. E-mail: fmartine{at}umich.edu
(Received in original form March 15, 2001 and accepted in revised form June 17, 2001).
Acknowledgments:
Supported by NHLBI Grants P50HL46487, and 1 K24 HL04212-01 from the National Heart, Lung and Blood Institute NIH/NCRR 3 MO1 RR00042-33S3, NIH/
NIA P60 AG08808-06, from the National Institutes of Health.
| |
References |
|---|
|
|
|---|
1. Bjoraker JA, Ryu JH, Edwin MK, Myers JL, Tazelaar HD, Schoreder DR, Offord KP. Prognostic significance of histopathologic subsets in idiopathic pulmonary fibrosis. Am J Respir Crit Care Med 1998; 157: 199-203 .
2.
Daniil ZD,
Gilchrist FC,
Nicholson AG,
Hansell DM,
Harris J,
Colby TV,
duBois RM.
A histologic pattern of nonspecific interstitial pneumonia is associated with a better prognosis than usual interstitial pneumonia in patients with cryptogenic fibrosing alveolitis.
Am J Respir
Crit Care Med
1999;
160:
899-905
3. Travis WD, Matsui K, Moss J, Ferrans VJ. Idiopathic nonspecific interstitial pneumonia: Prognostic significance of cellular and fibrosing patterns. Am J Surg Pathol 2000; 24: 19-33 [Medline].
4. Nagai S, Kitaichi M, Itoh H, Nishimura K, Izumi T, Colby TV. Idiopathic nonspecific interstitial pneumonia/fibrosis: comparison with idiopathic pulmonary fibrosis and BOOP. Eur Respir J 1998; 12: 1010-1019 [Abstract].
5.
Nicholson AG,
Colby TV,
DuBois RM,
Hansell DM,
Wells AU.
The
prognostic significance of the histologic pattern of interstitial pneumonia in patients presenting with the clinical entity of cryptogenic fibrosing alveolitis.
Am J Respir Crit Care Med
2000;
162:
2213-2217
6. Katzenstein ALA, Fiorelli RF. Nonspecific interstitial pneumonia/fibrosis. Histologic features and clinical significance. Am J Surg Pathol 1994; 18: 136-147 [Medline].
7. Ryu JH, Colby TV, Hartman TE. Idiopathic pulmonary fibrosis: current concepts. Mayo Clin Proc 1998; 73: 1085-1101 [Abstract].
8. American Thoracic Society. Idiopathic pulmonary fibrosis: Diagnosis and treatment. International consensus statement. Am J Respir Crit Care Med 2000;161:646-664.
9.
Katzenstein ALA,
Myers JL.
Idiopathic pulmonary fibrosis. Clinical relevance of pathologic classification.
Am J Respir Crit Care Med
1998;
157:
1301-1315
10. Hansell DM. High-resolution computed tomography in the evaluation of fibrosing alveolitis. Clin Chest Med 1999; 20: 739-760 [Medline].
11. Gay SE, Kazerooni EA, Toews GB, Lynch III JP, Gross BH, Cascade PN, Spizarny DL, Flint A, Schork MA, Whyte RI, et al. Idiopathic pulmonary fibrosis. Predicting response to therapy and survival. Am J Respir Crit Care Med 1998;157:1063-1072.
12. Flaherty KR, Toews GB, Lynch III JP, Kazerooni EA, Gross BH, Strawderman RL, Hariharan K, Flint A, Martinez FJ. Steroids in idiopathic pulmonary fibrosis: a prospective assessment of adverse reactions, response to therapy, and survival. Am J Med 2001;110:278-282.
13.
Flint A,
Martinez FJ,
Young ML,
Whyte RI,
Toews GB,
Lynch JP III..
Influence of sample and number and biopsy site on the histologic diagnosis of diffuse lung disease.
Ann Thorac Surg
1995;
60:
1607-1608
14. Kazerooni EA, Martinez FJ, Flint A, Jamadar DA, Gross BH, Spizarny DL, Cascade PN, Whyte RI, Lynch III JP, Toews G. Thin-section CT obtained at 10 mm increments versus three-level thin-section CT for idiopathic pulmonary fibrosis: correlation with pathologic scoring. Am J Roentgenol 1997;169:977-983.
15. Winterbauer RH, Hammar SP, Hallman KO, Hays JE, Pardee NE, Morgan EH, Allen JD, Moores KD, Bush W, Walker JH. Diffuse interstitial pneumonitis. Clinicopathologic correlations in 20 patients treated with prednisone/azathioprine. Am J Med 1978; 65: 661-672 [Medline].
16. Cherniack RM, Colby TV, Flint A, Thurlbeck WM, Waldron J, Ackerson L, King Jr TE. Quantitative assessment of lung pathology in idiopathic pulmonary fibrosis. The BAL Cooperative Group Steering Committee. Am Rev Respir Dis 1991;144:892-900.
17. Fujita J, Yamadori I, Bandoh S, Mizobuchi K, Suemitsu I, Nakamura Y, Ohtsuki Y, Takahara J. Clinical features of three fatal cases of non-specific interstitial pneumonia. Intern Med 2000; 39: 407-411 [Medline].
18.
Park LS,
Lee KS,
Kim JS,
Park CS,
Suh YL,
Choi DL,
Kim KJ.
Nonspecific interstitial pneumonia with fibrosis: radiographic and CT findings
in seven patients.
Radiology
1995;
195:
645-648
19.
Kim TS,
Lee KS,
Chung MP,
Han J,
Park JS,
Hwang JH,
Kwon OJ,
Rhee CH.
Nonspecific interstitial pneumonia with fibrosis: high-resolution CT and pathologic findings.
AJR
1998;
171:
1645-1650
20.
Johkoh T,
Muller NL,
Cartier Y,
Kavanagh PV,
Hartman TE,
Akira M,
Ichikado K,
Ando M,
Nakamura H.
Idiopathic interstitial pneumonias: diagnostic accuracy of thin-section CT in 129 patients.
Radiology
1999;
211:
555-560
21. Hartman TE, Swensen SJ, Hansell DM, Colby TV, Myers JL, Tazelaar HD, Nicholson AG, Wells AU, Ryu Jay H, Mu'adhdin DE, et al. Nonspecific interstitial pneumonia: variable appearance at high-resolution chest CT. Radiology 2000;217:701-705.
22. Nishiyama O, Kondoh Y, Taniguchi H, Yamaki K, Suzuki R, Yokoi T, Takagi K. Serial high-resolution CT findings in nonspecific interstitial pneumonia/fibrosis. J Comput Assist Tomogr 2000; 24: 41-46 [Medline].
23. Kim EY, Lee KS, Chung MP, Kwon OJ, Kim TS, Hwang JH. Nonspecific interstitial pneumonia with fibrosis: serial high-resolution CT findings with functional correlation. AJR 1999; 173: 1734-1739 .
24.
Hartman TE,
Primack SL,
Kang EY,
Swensen SJ,
Hansell DM,
McGuinness G,
Muller NL.
Disease progression in usual interstitial pneumonia compared with desquamative interstitial pneumonia.
Chest
1996;
110:
378-382
| |
APPENDIX |
|---|
The University of Michigan Fibrotic Lung Disease Network includes: D. Arenberg, C. Brennan-Martinez, W. Bria, D. Dahlgren, S. Gay, C. Grum, J. Hampton, K. Hariharan, M. Keane, T. Ojo, R. Paine, M. Peters-Golden, R. Simon, T. Sisson, T. Standiford, and R. Strieter, University of Michigan, Division of Pulmonary and Critical Care, Ann Arbor, MI; P. Bachwich, C. Easton, and J. Mazur, Internal Medicine Clinic, Alpena, MI; S. Chaparala, G. Harrington, and N. Potempa, The Lung Center, Battle Creek, MI; S. Manawar, and J. Summer, Bay City, MI; P. Hukku, and J. Sung, Clawson, MI; R, Babcock, Clinton Township, MI; J. Belen, M. Dunn, D. Maxwell, R. Reagle, R. Sherman, and S. Simecek, Pulmonary and Critical Care Medicine Consultants, Commerce, MI; L. Victor, Oakwood Hospital, Dearborn, MI; B. DiGiovine, M. Eichenhorn, R. Hyzy, J. Popovich, Jr, and D. Spizarny, Henry Ford Hospital, Detroit, MI; B. Rabinowitz, Botsford General Hospital, Farmington Hills, MI; G. Ferguson, P. Kaplan, S. Sklar, and W. VanderRoest, Pulmonary and Critical Care Specialists, Farmington Hills, MI; O. Filos, V. Rao, M.V. Thomas, J. Varghese, J. Vyskocil, and F. Wadenstorer, Pulmonary Associates, PC, Flint, MI; J. Cantor, W. Katz, R. Johnson, Jr, D. Listello, and J. Wilt, Grand Valley Internal Medicine, Grand Rapids, MI; C. Acharya, W. Couwenhoven, T. Daum, M. Harrison, M. Koets, G. Sandman, and G. VanOtteren, Michigan Medical Professional Company, Grand Rapids, MI; S. Kraker, Michigan Medical, PC, Holland, MI; M. Greenberger, A. O'Neill, and D. Wu, Huntington Woods, MI; R.C. Albertson III, J. Chauncey, T. Murray, and G. Patten, Pulmonary Clinics of Southern Michigan, Jackson, MI; T. Abraham, J. Dirks, B. Dykstra, G. Grambau, and J. Schoell, Associated Pulmonary and Critical Care Specialists, PC, Kalamazoo, MI; R. Brush, S. Jefferson, J. Miller, S. Schuldheisz, and M. Warlick, Pulmonary and Cricial Care Associates, PC, Kalamazoo, MI; J. Armstrong, A. Atkinson, T. Kantra, L. Rawsthorne, and D. Young, Pulmonary and Critical Care Consultants, Lansing, MI; A. Abbasi, C.M. Gera, G. Kashyap, and J. Morlock, Pulmonary Services, Lansing, MI; S. Danek, and A. Saari, Respiratory Medicine, Marquette, MI; E. Obeid, Central Michigan Healthcare System, Mt. Pleasant, MI; D. Hoch, and A. Kleaveland, Muskegon Pulmonary Associates, Muskegon, MI; A. Allam, and M.A. Gad Jr, Owosso Medical Group, Owosso, MI; A. Desai, U. Dhanjal, and A. Sethi, Lung Associates, Pontiac, MI; F. Ahmad, R. Elkus, L. Kaiser, L. Rosenthal, and D. Sak, St. Joseph's Hospital, Pontiac, MI; R. Ailani, M. Basha, A. Hadar, and S. Holstine, Physician HealthCare Network, Port Huron, MI; M.W. Al-Ameri, R. Go, and M. Kashlan, Pulmonary, Critical Care, and Sleep, PC, Rochester Hills, MI; K. Aggarwal, Rochester, MI; W. Hanna, and R. Marchese, Roseville, MI; R. Begle, D. Erb, K.P. Ravikrishnan, J. Seidman, and S. Sherman, William Beaumont Hospital, Royal Oak, MI; M. Ivey, Spring Lake, MI; S. Deskins, A. Palmer, and S. Shastri, Lakeside Healthcare Specialists, St. Joseph, MI; R. DiLisio, S. Galens, K. Grady, D. Harrington, R. Herbert, C. Hughes, J. Lee, A. Starrico, K. Stevens, M. Trunsky, and W. Ventimiglia, Pulmonary and Critical Care Associates, St. Clair Shores, MI and Troy, MI; D. Mahajan, Taylor, MI; H. Kaplan, and L. Tankanow, Pulmonary Medicine Associates, Warren, MI; M. Pensler, Henry Ford Wyandotte Hospital, Wyandotte, MI; F.O. Horton III, A. Nathanson, and R. Wainz, Toledo Pulmonary and Sleep Specialists, Toledo, OH.
This article has been cited by other articles:
![]() |
E. J. Kim, H. R. Collard, and T. E. King Jr Rheumatoid Arthritis-Associated Interstitial Lung Disease: The Relevance of Histopathologic and Radiographic Pattern Chest, November 1, 2009; 136(5): 1397 - 1405. [Abstract] [Full Text] [PDF] |
||||
![]() |
L. J. Vuga, A. Ben-Yehudah, E. Kovkarova-Naumovski, T. Oriss, K. F. Gibson, C. Feghali-Bostwick, and N. Kaminski WNT5A Is a Regulator of Fibroblast Proliferation and Resistance to Apoptosis Am. J. Respir. Cell Mol. Biol., November 1, 2009; 41(5): 583 - 589. [Abstract] [Full Text] [PDF] |
||||
![]() |
J. J. Swigris, J. Swick, F. S. Wamboldt, D. Sprunger, R. du Bois, A. Fischer, G. P. Cosgrove, S. K. Frankel, E. R. Fernandez-Perez, D. Kervitsky, et al. Heart Rate Recovery After 6-Min Walk Test Predicts Survival in Patients With Idiopathic Pulmonary Fibrosis Chest, September 1, 2009; 136(3): 841 - 848. [Abstract] [Full Text] [PDF] |
||||
![]() |
H. Yasuoka, Y. Yamaguchi, and C. A. Feghali-Bostwick The Pro-Fibrotic Factor IGFBP-5 Induces Lung Fibroblast and Mononuclear Cell Migration Am. J. Respir. Cell Mol. Biol., August 1, 2009; 41(2): 179 - 188. [Abstract] [Full Text] [PDF] |
||||
![]() |
H. Yasuoka, E. Hsu, X. D. Ruiz, R. A. Steinman, A. M.K. Choi, and C. A. Feghali-Bostwick The Fibrotic Phenotype Induced by IGFBP-5 Is Regulated by MAPK Activation and Egr-1-Dependent and -Independent Mechanisms Am. J. Pathol., August 1, 2009; 175(2): 605 - 615. [Abstract] [Full Text] [PDF] |
||||
![]() |
K. Konishi, K. F. Gibson, K. O. Lindell, T. J. Richards, Y. Zhang, R. Dhir, M. Bisceglia, S. Gilbert, S. A. Yousem, J. W. Song, et al. Gene Expression Profiles of Acute Exacerbations of Idiopathic Pulmonary Fibrosis Am. J. Respir. Crit. Care Med., July 15, 2009; 180(2): 167 - 175. [Abstract] [Full Text] [PDF] |
||||
![]() |
S. Ohshimo, F. Bonella, A. Cui, M. Beume, N. Kohno, J. Guzman, and U. Costabel Significance of Bronchoalveolar Lavage for the Diagnosis of Idiopathic Pulmonary Fibrosis Am. J. Respir. Crit. Care Med., June 1, 2009; 179(11): 1043 - 1047. [Abstract] [Full Text] [PDF] |
||||
![]() |
M. Akira, Y. Inoue, M. Kitaichi, S. Yamamoto, T. Arai, and K. Toyokawa Usual Interstitial Pneumonia and Nonspecific Interstitial Pneumonia with and without Concurrent Emphysema: Thin-Section CT Findings Radiology, April 1, 2009; 251(1): 271 - 279. [Abstract] [Full Text] [PDF] |
||||
![]() |
T. Akashi, T. Takemura, N. Ando, Y. Eishi, M. Kitagawa, T. Takizawa, M. Koike, Y. Ohtani, Y. Miyazaki, N. Inase, et al. Histopathologic Analysis of Sixteen Autopsy Cases of Chronic Hypersensitivity Pneumonitis and Comparison With Idiopathic Pulmonary Fibrosis/Usual Interstitial Pneumonia Am J Clin Pathol, March 1, 2009; 131(3): 405 - 415. [Abstract] [Full Text] [PDF] |
||||
![]() |
C. R. Kliment, J. M. Englert, B. R. Gochuico, G. Yu, N. Kaminski, I. Rosas, and T. D. Oury Oxidative Stress Alters Syndecan-1 Distribution in Lungs with Pulmonary Fibrosis J. Biol. Chem., February 6, 2009; 284(6): 3537 - 3545. [Abstract] [Full Text] [PDF] |
||||
![]() |
M. Kreider and R. M. Kotloff Selection of Candidates for Lung Transplantation Proceedings of the ATS, January 15, 2009; 6(1): 20 - 27. [Abstract] [Full Text] [PDF] |
||||
![]() |
J. P. Lynch III Idiopathic Pulmonary Fibrosis, Nonspecific Interstitial Pneumonia/Fibrosis, and Sarcoidosis ACCP Pulmonary Med Brd Rev, January 1, 2009; 25(0): 635 - 686. [Full Text] [PDF] |
||||
![]() |
S. J. Kligerman, S. Groshong, K. K Brown, and D. A. Lynch Nonspecific Interstitial Pneumonia: Radiologic, Clinical, and Pathologic Considerations1 RadioGraphics, January 1, 2009; 29(1): 73 - 87. [Abstract] [Full Text] [PDF] |
||||
![]() |
W. Wuyts Surgical lung biopsy is not the golden standard in diagnosis of diffuse parenchymal lung diseases Eur. J. Cardiothorac. Surg., December 1, 2008; 34(6): 1271 - 1272. [Full Text] [PDF] |
||||
![]() |
H. Arakawa, K. Fujimoto, K. Honma, N. Suganuma, H. Morikubo, Y. Saito, H. Shida, and Y. Kaji Progression from Near-Normal to End-Stage Lungs in Chronic Interstitial Pneumonia Related to Silica Exposure: Long-Term CT Observations Am. J. Roentgenol., October 1, 2008; 191(4): 1040 - 1045. [Abstract] [Full Text] [PDF] |
||||
![]() |
K. M. Shin, K. S. Lee, M. P. Chung, J. Han, Y. A Bae, T. S. Kim, and M. J. Chung Prognostic Determinants among Clinical, Thin-Section CT, and Histopathologic Findings for Fibrotic Idiopathic Interstitial Pneumonias: Tertiary Hospital Study Radiology, October 1, 2008; 249(1): 328 - 337. [Abstract] [Full Text] [PDF] |
||||
![]() |
A U Wells, N Hirani, and on behalf of the BTS Interstitial Lung Disease Gui Interstitial lung disease guideline Thorax, September 1, 2008; 63(Suppl_5): v1 - v58. [Full Text] [PDF] |
||||
![]() |
V. Hanak, J. M. Golbin, T. E. Hartman, and J. H. Ryu High-Resolution CT Findings of Parenchymal Fibrosis Correlate With Prognosis in Hypersensitivity Pneumonitis Chest, July 1, 2008; 134(1): 133 - 138. [Abstract] [Full Text] [PDF] |
||||
![]() |
W. D. Travis, G. Hunninghake, T. E. King Jr., D. A. Lynch, T. V. Colby, J. R. Galvin, K. K. Brown, M. P. Chung, J.-F. Cordier, R. M. du Bois, et al. Idiopathic Nonspecific Interstitial Pneumonia: Report of an American Thoracic Society Project Am. J. Respir. Crit. Care Med., June 15, 2008; 177(12): 1338 - 1347. [Abstract] [Full Text] [PDF] |
||||
![]() |
M. K. Han, S. Murray, C. D. Fell, K. R. Flaherty, G. B. Toews, J. Myers, T. V. Colby, W. D. Travis, E. A. Kazerooni, B. H. Gross, et al. Sex differences in physiological progression of idiopathic pulmonary fibrosis Eur. Respir. J., June 1, 2008; 31(6): 1183 - 1188. [Abstract] [Full Text] [PDF] |
||||
![]() |
P. Rogliani, M. Mura, M. Assunta Porretta, and C. Saltini Review: New perspectives in the treatment of idiopathic pulmonary fibrosis Therapeutic Advances in Respiratory Disease, April 1, 2008; 2(2): 75 - 93. [Abstract] [PDF] |
||||
![]() |
A. N. Rubinowitz, M. Moon, and R. Homer A 34-Year-Old Man Presenting With Gradual Onset of Shortness of Breath and Interstitial Lung Disease Chest, April 1, 2008; 133(4): 1041 - 1047. [Full Text] [PDF] |
||||
![]() |
M. Thomeer, M. Demedts, J. Behr, R. Buhl, U. Costabel, C. D. R. Flower, J. Verschakelen, F. Laurent, A. G. Nicholson, E. K. Verbeken, et al. Multidisciplinary interobserver agreement in the diagnosis of idiopathic pulmonary fibrosis Eur. Respir. J., March 1, 2008; 31(3): 585 - 591. [Abstract] [Full Text] [PDF] |
||||
![]() |
T J Williams and J W Wilson Challenges in pulmonary fibrosis: 7 {middle dot} Novel therapies and lung transplantation Thorax, March 1, 2008; 63(3): 277 - 284. [Abstract] [Full Text] [PDF] |
||||
![]() |
H. Sumikawa, T. Johkoh, T. V. Colby, K. Ichikado, M. Suga, H. Taniguchi, Y. Kondoh, T. Ogura, H. Arakawa, K. Fujimoto, et al. Computed Tomography Findings in Pathological Usual Interstitial Pneumonia: Relationship to Survival Am. J. Respir. Crit. Care Med., February 15, 2008; 177(4): 433 - 439. [Abstract] [Full Text] [PDF] |
||||
![]() |
S. K. Huang, S. H. Wettlaufer, C. M. Hogaboam, K. R. Flaherty, F. J. Martinez, J. L. Myers, T. V. Colby, W. D. Travis, G. B. Toews, and M. Peters-Golden Variable Prostaglandin E2 Resistance in Fibroblasts from Patients with Usual Interstitial Pneumonia Am. J. Respir. Crit. Care Med., January 1, 2008; 177(1): 66 - 74. [Abstract] [Full Text] [PDF] |
||||
![]() |
L. S Mackay, R. L Anderson, G. Parry, J. Lordan, P. A Corris, and A. J Fisher Pulmonary fibrosis: rate of disease progression as a trigger for referral for lung transplantation Thorax, December 1, 2007; 62(12): 1069 - 1073. [Abstract] [Full Text] [PDF] |
||||
![]() |
R. du Bois and T. E King Jr Challenges in pulmonary fibrosis {middle dot} 5: The NSIP/UIP debate Thorax, November 1, 2007; 62(11): 1008 - 1012. [Abstract] [Full Text] [PDF] |
||||
![]() |
D. S. Kim and S. Nagai Idiopathic Nonspecific Interstitial Pneumonia: An Unrecognized Autoimmune Disease? Am. J. Respir. Crit. Care Med., October 1, 2007; 176(7): 632 - 633. [Full Text] [PDF] |
||||
![]() |
A. U Wells, A. G Nicholson, and D. M Hansell Challenges in pulmonary fibrosis {middle dot} 4: Smoking-induced diffuse interstitial lung diseases Thorax, October 1, 2007; 62(10): 904 - 910. [Abstract] [Full Text] [PDF] |
||||
![]() |
H. R. Collard, B. B. Moore, K. R. Flaherty, K. K. Brown, R. J. Kaner, T. E. King Jr., J. A. Lasky, J. E. Loyd, I. Noth, M. A. Olman, et al. Acute Exacerbations of Idiopathic Pulmonary Fibrosis Am. J. Respir. Crit. Care Med., October 1, 2007; 176(7): 636 - 643. [Abstract] [Full Text] [PDF] |
||||
![]() |
B. N. Gomperts and R. M. Strieter Fibrocytes in lung disease J. Leukoc. Biol., September 1, 2007; 82(3): 449 - 456. [Abstract] [Full Text] [PDF] |
||||
![]() |
G. W. Hunninghake and M. I. Schwarz State of the Art. Does Current Knowledge Explain the Pathogenesis of Idiopathic Pulmonary Fibrosis?: A Perspective Proceedings of the ATS, August 15, 2007; 4(5): 449 - 452. [Abstract] [Full Text] [PDF] |
||||
![]() |
C. A. Feghali-Bostwick, C. G. Tsai, V. G. Valentine, S. Kantrow, M. W. Stoner, J. M. Pilewski, A. Gadgil, M. P. George, K. F. Gibson, A. M. K. Choi, et al. Cellular and Humoral Autoreactivity in Idiopathic Pulmonary Fibrosis J. Immunol., August 15, 2007; 179(4): 2592 - 2599. [Abstract] [Full Text] [PDF] |
||||
![]() |
I. Noth and F. J. Martinez Recent Advances in Idiopathic Pulmonary Fibrosis Chest, August 1, 2007; 132(2): 637 - 650. [Abstract] [Full Text] [PDF] |
||||
![]() |
J. H. Ryu, C. E. Daniels, T. E. Hartman, and E. S. Yi Diagnosis of Interstitial Lung Diseases Mayo Clin. Proc., August 1, 2007; 82(8): 976 - 986. [Abstract] [Full Text] [PDF] |
||||
![]() |
K. R. Flaherty, A.-C. Andrei, T. E. King Jr., G. Raghu, T. V. Colby, A. Wells, N. Bassily, K. Brown, R. du Bois, A. Flint, et al. Idiopathic Interstitial Pneumonia: Do Community and Academic Physicians Agree on Diagnosis? Am. J. Respir. Crit. Care Med., May 15, 2007; 175(10): 1054 - 1060. [Abstract] [Full Text] [PDF] |
||||
![]() |
C. Mueller-Mang, C. Grosse, K. Schmid, L. Stiebellehner, and A. A. Bankier What Every Radiologist Should Know about Idiopathic Interstitial Pneumonias RadioGraphics, May 1, 2007; 27(3): 595 - 615. [Abstract] [Full Text] [PDF] |
||||
![]() |
S. Huang, S. H. Wettlaufer, C. Hogaboam, D. M. Aronoff, and M. Peters-Golden Prostaglandin E2 inhibits collagen expression and proliferation in patient-derived normal lung fibroblasts via E prostanoid 2 receptor and cAMP signaling Am J Physiol Lung Cell Mol Physiol, February 1, 2007; 292(2): L405 - L413. [Abstract] [Full Text] [PDF] |
||||
![]() |
I. V. Yang, L. H. Burch, M. P. Steele, J. D. Savov, J. W. Hollingsworth, E. McElvania-Tekippe, K. G. Berman, M. C. Speer, T. A. Sporn, K. K. Brown, et al. Gene Expression Profiling of Familial and Sporadic Interstitial Pneumonia Am. J. Respir. Crit. Care Med., January 1, 2007; 175(1): 45 - 54. [Abstract] [Full Text] [PDF] |
||||
![]() |
S. Mukherjee and M. Spiteri Transbronchial biopsy and usual interstitial pneumonia: a step backward in disease management? Chest, November 1, 2006; 130(5): 1628 - 1628. [Full Text] [PDF] |
||||
![]() |
D. A. Zisman and A.-L. A. Katzenstein Transbronchial Biopsy and Usual Interstitial Pneumonia: A Step Forward in Disease Management Chest, November 1, 2006; 130(5): 1628 - 1629. [Full Text] [PDF] |
||||
![]() |
K. R. Flaherty, A.-C. Andrei, S. Murray, C. Fraley, T. V. Colby, W. D. Travis, V. Lama, E. A. Kazerooni, B. H. Gross, G. B. Toews, et al. Idiopathic Pulmonary Fibrosis: Prognostic Value of Changes in Physiology and Six-Minute-Walk Test Am. J. Respir. Crit. Care Med., October 1, 2006; 174(7): 803 - 809. [Abstract] [Full Text] [PDF] |
||||
![]() |
H. Sumikawa, T. Johkoh, K. Ichikado, H. Taniguchi, Y. Kondoh, K. Fujimoto, U. Tateishi, T. Hiramatsu, A. Inoue, J. Natsag, et al. Usual Interstitial Pneumonia and Chronic Idiopathic Interstitial Pneumonia: Analysis of CT Appearance in 92 Patients Radiology, October 1, 2006; 241(1): 258 - 266. [Abstract] [Full Text] [PDF] |
||||
![]() |
C. K. Katikireddy, G. Krishna, T. Keifer, W. Kuschner, and G. Rosen A 35-year-old man with Fever, dyspnea, and diffuse reticular opacities. Chest, February 1, 2006; 129(2): 482 - 487. [Full Text] [PDF] |
||||
![]() |
V. J. Thannickal and A. U. Wells Classification of Interstitial Pneumonias: What Do Gene Expression Profiles Tell Us? Am. J. Respir. Crit. Care Med., January 15, 2006; 173(2): 141 - 142. [Full Text] [PDF] |
||||
![]() |
M. Selman, A. Pardo, L. Barrera, A. Estrada, S. R. Watson, K. Wilson, N. Aziz, N. Kaminski, and A. Zlotnik Gene Expression Profiles Distinguish Idiopathic Pulmonary Fibrosis from Hypersensitivity Pneumonitis Am. J. Respir. Crit. Care Med., January 15, 2006; 173(2): 188 - 198. [Abstract] [Full Text] [PDF] |
||||
![]() |
F. J. Martinez Idiopathic Interstitial Pneumonias: Usual Interstitial Pneumonia versus Nonspecific Interstitial Pneumonia. Proceedings of the ATS, January 1, 2006; 3(1): 81 - 95. [Abstract] [Full Text] [PDF] |
||||
![]() |
D. S. Kim, H. R. Collard, and T. E. King Jr. Classification and natural history of the idiopathic interstitial pneumonias. Proceedings of the ATS, January 1, 2006; 3(4): 285 - 292. [Abstract] [Full Text] [PDF] |
||||
![]() |
S. Misumi and D. A. Lynch Idiopathic pulmonary fibrosis/usual interstitial pneumonia: imaging diagnosis, spectrum of abnormalities, and temporal progression. Proceedings of the ATS, January 1, 2006; 3(4): 307 - 314. [Abstract] [Full Text] [PDF] |
||||
![]() |
D. W. Visscher and J. L. Myers Histologic spectrum of idiopathic interstitial pneumonias. Proceedings of the ATS, January 1, 2006; 3(4): 322 - 329. [Abstract] [Full Text] [PDF] |
||||
![]() |
Z. A. Aziz, A. U. Wells, E. D. Bateman, S. J. Copley, S. R. Desai, J. C. Grutters, D. G. Milne, G. D. Phillips, D. Smallwood, J. Wiggins, et al. Interstitial Lung Disease: Effects of Thin-Section CT on Clinical Decision Making Radiology, December 12, 2005; (2005) 2381041823. [Abstract] [Full Text] |
||||
![]() |
C. A. Souza, N. L. Muller, J. Flint, J. L. Wright, and A. Churg Idiopathic Pulmonary Fibrosis: Spectrum of High-Resolution CT Findings Am. J. Roentgenol., December 1, 2005; 185(6): 1531 - 1539. [Abstract] [Full Text] [PDF] |
||||
![]() |
M. Demedts, J. Behr, R. Buhl, U. Costabel, R. Dekhuijzen, H. M. Jansen, W. MacNee, M. Thomeer, B. Wallaert, F. Laurent, et al. High-Dose Acetylcysteine in Idiopathic Pulmonary Fibrosis. N. Engl. J. Med., November 24, 2005; 353(21): 2229 - 2242. [Abstract] [Full Text] [PDF] |
||||
![]() |
M. P. Steele, M. C. Speer, J. E. Loyd, K. K. Brown, A. Herron, S. H. Slifer, L. H. Burch, M. M. Wahidi, J. A. Phillips III, T. A. Sporn, et al. Clinical and Pathologic Features of Familial Interstitial Pneumonia Am. J. Respir. Crit. Care Med., November 1, 2005; 172(9): 1146 - 1152. [Abstract] [Full Text] [PDF] |
||||
![]() |
K. O. Leslie Historical Perspective: A Pathologic Approach to the Classification of Idiopathic Interstitial Pneumonias Chest, November 1, 2005; 128(5_suppl_1): 513S - 519S. [Abstract] [Full Text] [PDF] |
||||
![]() |
M. C. Fishbein Diagnosis: To Biopsy or Not to Biopsy: Assessing the Role of Surgical Lung Biopsy in the Diagnosis of Idiopathic Pulmonary Fibrosis Chest, November 1, 2005; 128(5_suppl_1): 520S - 525S. [Abstract] [Full Text] [PDF] |
||||
![]() |
R. M. Strieter Pathogenesis and Natural History of Usual Interstitial Pneumonia: The Whole Story or the Last Chapter of a Long Novel Chest, November 1, 2005; 128(5_suppl_1): 526S - 532S. [Abstract] [Full Text] [PDF] |
||||
![]() |
L. Tiitto, U. Heiskanen, R. Bloigu, P. Paakko, V. Kinnula, and R. Kaarteenaho-Wiik Thoracoscopic Lung Biopsy Is a Safe Procedure in Diagnosing Usual Interstitial Pneumonia Chest, October 1, 2005; 128(4): 2375 - 2380. [Abstract] [Full Text] [PDF] |
||||
![]() |
S. A. Papiris, A. Kollintza, P. Kitsanta, G. Kapotsis, M. Karatza, J. Milic-Emili, C. Roussos, and Z. Daniil Relationship of BAL and Lung Tissue CD4+ and CD8+ T Lymphocytes, and Their Ratio in Idiopathic Pulmonary Fibrosis Chest, October 1, 2005; 128(4): 2971 - 2977. [Abstract] [Full Text] [PDF] |
||||
![]() |
T. E. King Jr. Clinical Advances in the Diagnosis and Therapy of the Interstitial Lung Diseases Am. J. Respir. Crit. Care Med., August 1, 2005; 172(3): 268 - 279. [Abstract] [Full Text] [PDF] |
||||
![]() |
M. E. Halkos, A. A. Gal, F. Kerendi, D. L. Miller, and J. I. Miller Jr Role of Thoracic Surgeons in the Diagnosis of Idiopathic Interstitial Lung Disease Ann. Thorac. Surg., June 1, 2005; 79(6): 2172 - 2179. [Abstract] [Full Text] [PDF] |
||||
![]() |
H.-K. Lee, D. S. Kim, B. Yoo, J. B. Seo, J.-Y. Rho, T. V. Colby, and M. Kitaichi Histopathologic Pattern and Clinical Features of Rheumatoid Arthritis-Associated Interstitial Lung Disease Chest, June 1, 2005; 127(6): 2019 - 2027. [Abstract] [Full Text] [PDF] |
||||
![]() |
I. Ito, S. Nagai, M. Kitaichi, A. G. Nicholson, T. Johkoh, S. Noma, D. S. Kim, T. Handa, T. Izumi, and M. Mishima Pulmonary Manifestations of Primary Sjogren's Syndrome: A Clinical, Radiologic, and Pathologic Study Am. J. Respir. Crit. Care Med., March 15, 2005; 171(6): 632 - 638. [Abstract] [Full Text] [PDF] |
||||
![]() |
Y. Jegal, D. S. Kim, T. S. Shim, C.-M. Lim, S. Do Lee, Y. Koh, W. S. Kim, W. D. Kim, J. S. Lee, W. D. Travis, et al. Physiology Is a Stronger Predictor of Survival than Pathology in Fibrotic Interstitial Pneumonia Am. J. Respir. Crit. Care Med., March 15, 2005; 171(6): 639 - 644. [Abstract] [Full Text] [PDF] |
||||
![]() |
S. D. Nathan Lung Transplantation: Disease-Specific Considerations for Referral Chest, March 1, 2005; 127(3): 1006 - 1016. [Abstract] [Full Text] [PDF] |
||||
![]() |
J. J. Swigris, W. G. Kuschner, J. L. Kelsey, and M. K. Gould Idiopathic Pulmonary Fibrosis: Challenges and Opportunities for the Clinician and Investigator Chest, January 1, 2005; 127(1): 275 - 283. [Abstract] [Full Text] [PDF] |
||||
![]() |
A. U. Wells Histopathologic Diagnosis in Diffuse Lung Disease: An Ailing Gold Standard Am. J. Respir. Crit. Care Med., October 15, 2004; 170(8): 828 - 829. [Full Text] [PDF] |
||||
![]() |
K. R. Flaherty, T. E. King Jr., G. Raghu, J. P. Lynch III, T. V. Colby, W. D. Travis, B. H. Gross, E. A. Kazerooni, G. B. Toews, Q. Long, et al. Idiopathic Interstitial Pneumonia: What Is the Effect of a Multidisciplinary Approach to Diagnosis? Am. J. Respir. Crit. Care Med., October 15, 2004; 170(8): 904 - 910. [Abstract] [Full Text] [PDF] |
||||
![]() |
T Fischer, J H Reynolds, and S E Trotter The idiopathic interstitial pneumonias: a beginner's guide Imaging, October 1, 2004; 16(1): 37 - 49. [Abstract] [Full Text] [PDF] |
||||
![]() |
M. P. Keane Chemokine Profiling in Pulmonary Fibrosis: Ready for Prime Time? Am. J. Respir. Crit. Care Med., September 1, 2004; 170(5): 475 - 476. [Full Text] [PDF] |
||||
![]() |
E. S. Choi, C. Jakubzick, K. J. Carpenter, S. L. Kunkel, H. Evanoff, F. J. Martinez, K. R. Flaherty, G. B. Toews, T. V. Colby, E. A. Kazerooni, et al. Enhanced Monocyte Chemoattractant Protein-3/CC Chemokine Ligand-7 in Usual Interstitial Pneumonia Am. J. Respir. Crit. Care Med., September 1, 2004; 170(5): 508 - 515. [Abstract] [Full Text] [PDF] |
||||
![]() |
M. P. Keane Angiogenesis and Pulmonary Fibrosis: Feast or Famine? Am. J. Respir. Crit. Care Med., August 1, 2004; 170(3): 207 - 209. [Full Text] [PDF] |
||||
![]() |
N R Simler, P E Brenchley, A W Horrocks, S M Greaves, P S Hasleton, and J J Egan Angiogenic cytokines in patients with idiopathic interstitial pneumonia Thorax, July 1, 2004; 59(7): 581 - 585. [Abstract] [Full Text] [PDF] |
||||
![]() |
H. R. Collard, J. H. Ryu, W. W. Douglas, M. I. Schwarz, D. Curran-Everett, T. E. King Jr., and K. K. Brown Combined Corticosteroid and Cyclophosphamide Therapy Does Not Alter Survival in Idiopathic Pulmonary Fibrosis Chest, June 1, 2004; 125(6): 2169 - 2174. [Abstract] [Full Text] [PDF] |
||||
![]() |
K. Williams, D. Malarkey, L. Cohn, D. Patrick, J. Dye, and G. Toews Identification of Spontaneous Feline Idiopathic Pulmonary Fibrosis: Morphology and Ultrastructural Evidence for a Type II Pneumocyte Defect Chest, June 1, 2004; 125(6): 2278 - 2288. [Abstract] [Full Text] [PDF] |
||||
![]() |
A G Nicholson, B J Addis, H Bharucha, C A Clelland, B Corrin, A R Gibbs, P S Hasleton, K M Kerr, N B N Ibrahim, S Stewart, et al. Inter-observer variation between pathologists in diffuse parenchymal lung disease Thorax, June 1, 2004; 59(6): 500 - 505. [Abstract] [Full Text] [PDF] |
||||
![]() |
C. Jakubzick, E. S. Choi, K. J. Carpenter, S. L. Kunkel, H. Evanoff, F. J. Martinez, K. R. Flaherty, G. B. Toews, T. V. Colby, W. D. Travis, et al. Human Pulmonary Fibroblasts Exhibit Altered Interleukin-4 and Interleukin-13 Receptor Subunit Expression in Idiopathic Interstitial Pneumonia Am. J. Pathol., June 1, 2004; 164(6): 1989 - 2001. [Abstract] [Full Text] [PDF] |
||||
![]() |
C Jakubzick, E S Choi, S L Kunkel, H Evanoff, F J Martinez, R K Puri, K R Flaherty, G B Toews, T V Colby, E A Kazerooni, et al. Augmented pulmonary IL-4 and IL-13 receptor subunit expression in idiopathic interstitial pneumonia J. Clin. Pathol., May 1, 2004; 57(5): 477 - 486. [Abstract] [Full Text] [PDF] |
||||
![]() |
D. S. Zander Idiopathic Interstitial Pneumonias and the Concept of the Trump Card Chest, February 1, 2004; 125(2): 359 - 360. [Full Text] [PDF] |
||||
![]() |
H. Monaghan, A. U. Wells, T. V. Colby, R. M. du Bois, D. M. Hansell, and A. G. Nicholson Prognostic Implications of Histologic Patterns in Multiple Surgical Lung Biopsies From Patients With Idiopathic Interstitial Pneumonias Chest, February 1, 2004; 125(2): 522 - 526. [Abstract] [Full Text] [PDF] |
||||
![]() |
V. N. Lama, K. R. Flaherty, G. B. Toews, T. V. Colby, W. D. Travis, Q. Long, S. Murray, E. A. Kazerooni, B. H. Gross, J. P. Lynch III, et al. Prognostic Value of Desaturation during a 6-Minute Walk Test in Idiopathic Interstitial Pneumonia Am. J. Respir. Crit. Care Med., November 1, 2003; 168(9): 1084 - 1090. [Abstract] [Full Text] [PDF] |
||||
![]() |
D. W. Kamp Idiopathic Pulmonary Fibrosis: The Inflammation Hypothesis Revisited Chest, October 1, 2003; 124(4): 1187 - 1190. [Full Text] [PDF] |
||||
![]() |
R. Vassallo, E. A. Jensen, T. V. Colby, J. H. Ryu, W. W. Douglas, T. E. Hartman, and A. H. Limper The Overlap Between Respiratory Bronchiolitis and Desquamative Interstitial Pneumonia in Pulmonary Langerhans Cell Histiocytosis: High-Resolution CT, Histologic, and Functional Correlations Chest, October 1, 2003; 124(4): 1199 - 1205. [Abstract] [Full Text] [PDF] |
||||
![]() |
N. Kaminski, J. A. Belperio, P. B. Bitterman, L. Chen, S. W. Chensue, A. M.K. Choi, S. Dacic, J. H. Dauber, R. M. du Bois, J. J. Enghild, et al. Idiopathic Pulmonary Fibrosis Am. J. Respir. Cell Mol. Biol., September 1, 2003; 29(3): S1 - 105. [Full Text] [PDF] |
||||
![]() |
K. R. Flaherty, J. A. Mumford, S. Murray, E. A. Kazerooni, B. H. Gross, T. V. Colby, W. D. Travis, A. Flint, G. B. Toews, J. P. Lynch III, et al. Prognostic Implications of Physiologic and Radiographic Changes in Idiopathic Interstitial Pneumonia Am. J. Respir. Crit. Care Med., September 1, 2003; 168(5): 543 - 548. [Abstract] [Full Text] [PDF] |
||||
![]() |
P. I. Latsi, R. M. du Bois, A. G. Nicholson, T. V. Colby, D. Bisirtzoglou, A. Nikolakopoulou, S. Veeraraghavan, D. M. Hansell, and A. U. Wells Fibrotic Idiopathic Interstitial Pneumonia: The Prognostic Value of Longitudinal Functional Trends Am. J. Respir. Crit. Care Med., September 1, 2003; 168(5): 531 - 537. [Abstract] [Full Text] [PDF] |
||||
![]() |
K. C. Meyer Interferon Gamma-1b Therapy for Idiopathic Pulmonary Fibrosis: Is the Cart Before the Horse? Mayo Clin. Proc., September 1, 2003; 78(9): 1073 - 1075. [PDF] |
||||
![]() |
C. Vogelmeier IPF or NSIP? That is the question Eur. Respir. J., August 1, 2003; 22(2): 191 - 192. [Full Text] [PDF] |
||||
![]() |
S. Veeraraghavan, P.I. Latsi, A.U. Wells, P. Pantelidis, A.G. Nicholson, T.V. Colby, P.L. Haslam, E.A. Renzoni, and R.M. du Bois BAL findings in idiopathic nonspecific interstitial pneumonia and usual interstitial pneumonia Eur. Respir. J., August 1, 2003; 22(2): 239 - 244. [Abstract] [Full Text] [PDF] |
||||
![]() |
Y.-W. Tang, J. E. Johnson, P. J. Browning, R. A. Cruz-Gervis, A. Davis, B. S. Graham, K. L. Brigham, J. A. Oates Jr., J. E. Loyd, and A. A. Stecenko Herpesvirus DNA Is Consistently Detected in Lungs of Patients with Idiopathic Pulmonary Fibrosis J. Clin. Microbiol., June 1, 2003; 41(6): 2633 - 2640. [Abstract] [Full Text] [PDF] |
||||
![]() |
K. R. Flaherty, T. V. Colby, W. D. Travis, G. B. Toews, J. Mumford, S. Murray, V. J. Thannickal, E. A. Kazerooni, B. H. Gross, J. P. Lynch III, et al. Fibroblastic Foci in Usual Interstitial Pneumonia: Idiopathic versus Collagen Vascular Disease Am. J. Respir. Crit. Care Med., May 15, 2003; 167(10): 1410 - 1415. [Abstract] [Full Text] [PDF] |
||||
![]() |
O. Ghekiere, B. Weynand, P. Collard, and E. Coche Progressive dyspnoea in a 40-yr-old female Eur. Respir. J., April 1, 2003; 21(4): 728 - 731. [Full Text] [PDF] |
||||
![]() |
A. U. Wells, S. R. Desai, M. B. Rubens, N. S. L. Goh, D. Cramer, A. G. Nicholson, T. V. Colby, R. M. du Bois, and D. M. Hansell Idiopathic Pulmonary Fibrosis: A Composite Physiologic Index Derived from Disease Extent Observed by Computed Tomography Am. J. Respir. Crit. Care Med., April 1, 2003; 167(7): 962 - 969. [Abstract] [Full Text] [PDF] |
||||
![]() |
K R Flaherty, E L Thwaite, E A Kazerooni, B H Gross, G B Toews, T V Colby, W D Travis, J A Mumford, S Murray, A Flint, et al. Radiological versus histological diagnosis in UIP and NSIP: survival implications Thorax, February 1, 2003; 58(2): 143 - 148. [Abstract] [Full Text] [PDF] |
||||
![]() |
M. J. Tobin Compliance (COMmunicate PLease wIth Less Abbreviations, Noun Clusters, and Exclusiveness) Am. J. Respir. Crit. Care Med., December 15, 2002; 166(12): 1534 - 1536. [Full Text] [PDF] |
||||
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| Proc. Am. Thorac. Soc. | Am. J. Respir. Cell Mol. Biol. |