• 제목/요약/키워드: Pulmonary interstitial fibrosis

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특발성 폐 섬유화증 환자에서 폐 생검후 발견된 폐 선암 치험 1예 (Reported Lung Adenocarcinoma with Idiopathic Pulmonary Fibrosis after Open Lung Biopsy)

  • 최창우;허균;이재욱;원용순;고은석;신화균
    • Journal of Chest Surgery
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    • 제37권12호
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    • pp.1032-1035
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    • 2004
  • 미만간질폐병에서 확진을 위해 개흉 폐 생검을 한다. 미만간질페병은 많은 경우에 있어서 페암과 병발한다. 미만간질페병환자의 폐생검후 발견된 폐 선암 증례 1예를 통해서, 미만간질폐병과 폐암의 상관관계의 고찰과, 폐 생검시 부위 및 생검 횟수에 대한 일반적 기준의 정립에 관해서 논의해보고자 문헌 고찰과 함께 보고한다.

특발성 간질성 폐렴의 영상 소견 (Radiologic Findings of Idiopathic Interstitial Pneumonia)

  • 박재성
    • Tuberculosis and Respiratory Diseases
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    • 제58권4호
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    • pp.330-343
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    • 2005
  • 특발성 간질성 폐렴은 폐포보다는 폐간질을 주로 침범하는 미만성 염증성 섬유화 병변으로 병변의 분류에 임상적 및 병리학적으로 많은 혼동과 변화를 겪어왔다. 최근에는 미국흉부학회와 유럽호흡기학회의 공동 모임에서 이 질환 군에 해당되는 모든 임상과들이 모여서 7가지의 병변으로 재분류 하였는데, 이는 Idiopathic pulmonary fibrosis, Nonspecific interstitial pneumonia, Cryptogenic organizing pneumonia, Acute interstitial pneumonia, Respiratory bronchiolitis interstitial lung disease, Desquamative interstitial pneumonia, Lymphocytic interstitial pneumonia 등이다. 이에 저자는 최근 분류에 의한 특발성 간질성 폐렴의 7가지 병변을 영상 소견을 중심으로 기술하고자 한다.

기관지 폐포 세정액의 세포학적 소견 (Cytologic Findings of Bronchoalveolar Lavage)

  • 권건영;조승제;박관규;장은숙
    • 대한세포병리학회지
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    • 제1권2호
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    • pp.129-138
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    • 1990
  • Bronchoalveolar lavage (BAL) has emerged as a useful technique for the study of pulmonary interstitial disorders. Several types of Information are provided by the evaluation of lavage fluid identification of cellular constituents helps to separate inflammatory process. Recently we have studied cellular constituents of BAL from three cases with histologically confirmed pulmonary sarcoidosis, idiopathic pulmonary fibrosis and hypereosinophilic syndrome. Pulmonary sarcoidosis showed a marked increase in lymphocytes, idiopathic pulmonary fibrosis revealed a predominance of neutrophils, and hypereosinophilic syndrome presented a marked increase in eosinophils in the lavage fluids.

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Korean Guidelines for Diagnosis and Management of Interstitial Lung Diseases: Part 1. Introduction

  • Park, Sung-Woo;Baek, Ae Rin;Lee, Hong Lyeol;Jeong, Sung Whan;Yang, Sei-Hoon;Kim, Yong Hyun;Chung, Man Pyo;Korean Interstitial Lung Diseases Study Group
    • Tuberculosis and Respiratory Diseases
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    • 제82권4호
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    • pp.269-276
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    • 2019
  • Idiopathic interstitial pneumonia (IIP) is a histologically identifiable pulmonary disease without a known cause that usually infiltrates the lung interstitium. IIP is largely classified into idiopathic pulmonary fibrosis, idiopathic non-specific interstitial pneumonia, respiratory bronchiolitis-interstitial lung disease (ILD), cryptogenic organizing pneumonia, desquamative interstitial pneumonia, and acute interstitial pneumonia. Each of these diseases has a different prognosis and requires specific treatment, and a multidisciplinary approach that combines chest high-resolution computed tomography (HRCT), histological findings, and clinical findings is necessary for their diagnosis. Diagnosis of IIP is made based on clinical presentation, chest HRCT findings, results of pulmonary function tests, and histological findings. For histological diagnosis, video-assisted thoracoscopic biopsy and transbronchial lung biopsy are used. In order to identify ILD associated with connective tissue disease, autoimmune antibody tests may also be necessary. Many biomarkers associated with disease prognosis have been recently discovered, and future research on their clinical significance is necessary. The diagnosis of ILD is difficult because patterns of ILD are both complicated and variable. Therefore, as with other diseases, accurate history taking and meticulous physical examination are crucial.

Prediction of the Development of Pulmonary Fibrosis Using Serial Thin-Section CT and Clinical Features in Patients Discharged after Treatment for COVID-19 Pneumonia

  • Minhua Yu;Ying Liu;Dan Xu;Rongguo Zhang;Lan Lan;Haibo Xu
    • Korean Journal of Radiology
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    • 제21권6호
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    • pp.746-755
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    • 2020
  • Objective: To identify predictors of pulmonary fibrosis development by combining follow-up thin-section CT findings and clinical features in patients discharged after treatment for COVID-19. Materials and Methods: This retrospective study involved 32 confirmed COVID-19 patients who were divided into two groups according to the evidence of fibrosis on their latest follow-up CT imaging. Clinical data and CT imaging features of all the patients in different stages were collected and analyzed for comparison. Results: The latest follow-up CT imaging showed fibrosis in 14 patients (male, 12; female, 2) and no fibrosis in 18 patients (male, 10; female, 8). Compared with the non-fibrosis group, the fibrosis group was older (median age: 54.0 years vs. 37.0 years, p = 0.008), and the median levels of C-reactive protein (53.4 mg/L vs. 10.0 mg/L, p = 0.002) and interleukin-6 (79.7 pg/L vs. 11.2 pg/L, p = 0.04) were also higher. The fibrosis group had a longer-term of hospitalization (19.5 days vs. 10.0 days, p = 0.001), pulsed steroid therapy (11.0 days vs. 5.0 days, p < 0.001), and antiviral therapy (12.0 days vs. 6.5 days, p = 0.012). More patients on the worst-state CT scan had an irregular interface (59.4% vs. 34.4%, p = 0.045) and a parenchymal band (71.9% vs. 28.1%, p < 0.001). On initial CT imaging, the irregular interface (57.1%) and parenchymal band (50.0%) were more common in the fibrosis group. On the worst-state CT imaging, interstitial thickening (78.6%), air bronchogram (57.1%), irregular interface (85.7%), coarse reticular pattern (28.6%), parenchymal band (92.9%), and pleural effusion (42.9%) were more common in the fibrosis group. Conclusion: Fibrosis was more likely to develop in patients with severe clinical conditions, especially in patients with high inflammatory indicators. Interstitial thickening, irregular interface, coarse reticular pattern, and parenchymal band manifested in the process of the disease may be predictors of pulmonary fibrosis. Irregular interface and parenchymal band could predict the formation of pulmonary fibrosis early.

Therapeutic Use of Stem Cell Transplantation for Cell Replacement or Cytoprotective Effect of Microvesicle Released from Mesenchymal Stem Cell

  • Choi, Moonhwan;Ban, Taehyun;Rhim, Taiyoun
    • Molecules and Cells
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    • 제37권2호
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    • pp.133-139
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    • 2014
  • Idiopathic pulmonary fibrosis (IPF) is the most common and severe type of idiopathic interstitial pneumonias (IIP), and which is currently no method was developed to restore normal structure and function. There are several reports on therapeutic effects of adult stem cell transplantations in animal models of pulmonary fibrosis. However, little is known about how mesenchymal stem cell (MSC) can repair the IPF. In this study, we try to provide the evidence to show that transplanted mesenchymal stem cells directly replace fibrosis with normal lung cells using IPF model mice. As results, transplanted MSC successfully integrated and differentiated into type II lung cell which express surfactant protein. In the other hand, we examine the therapeutic effects of microvesicle treatment, which were released from mesenchymal stem cells. Though the therapeutic effects of MV treatment is less than that of MSC treatment, MV treat-ment meaningfully reduced the symptom of IPF, such as collagen deposition and inflammation. These data suggest that stem cell transplantation may be an effective strategy for the treatment of pulmonary fibrosis via replacement and cytoprotective effect of microvesicle released from MSCs.

Dose-response Effects of Bleomycin on Inflammation and Pulmonary Fibrosis in Mice

  • Kim, Soo-Nam;Lee, Jin-Soo;Yang, Hyo-Seon;Cho, Jae-Woo;Kwon, Soon-Jin;Kim, Young-Beom;Her, Jeong-Doo;Cho, Kyu-Hyuk;Song, Chang-Woo;Lee, Kyu-Hong
    • Toxicological Research
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    • 제26권3호
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    • pp.217-222
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    • 2010
  • Many studies have reported that bleomycin, anti-cancer drug, induces pulmonary fibrosis as a side effect. However, few investigations have focused on the dose-response effects of bleomycin on pulmonary fibrosis. Therefore, in the present study, we investigated the effects of different doses of bleomycin in male mice. ICR mice were given 3 consecutive doses of bleomycin: 1, 2, or 4 mg/kg in bleomycin-treated (BT) groups and saline only in vehicle control (VC) groups. The animals were sacrificed at 7 and 24 days postinstillation. The severity of pulmonary fibrosis was evaluated according to inflammatory cell count and lactate dehydrogenase (LDH) activity in the broncho alveolar lavage fluid (BALF), and lung tissues were histologically evaluated after hematoxylin and eosin (H&E), and Masson's trichrome staining. BT groups exhibited changed cellular profiles in BAL fluid compared to the VC group, which had an increased number of total cells, neutrophils, and lymphocytes and a modest increase in the number of macrophages at 7 days post-bleomycin instillation. Moreover, BT groups showed a dose-dependent increase in LDH levels and inflammatory cell counts. However, at 24 days after treatment, collagen deposition, interstitial thickening, and granulomatous lesions were observed in the alveolar spaces in addition to a decrease in inflammatory cells. These results indicate that pulmonary fibrosis induced by 4 mg/kg bleomycin was more severe than that induced by 1 or 2 mg/kg. These data will be utilized in experimental animal models and as basic data to evaluate therapeutic candidates through non-invasive monitoring using the pulmonary fibrosis mouse model established in this study.

그라목손 중독에 의한 폐섬유화와 동반된 거대 폐기포 - 1례 보고 - (Giant Bulla with Pulmonary Fibrosis Caused by Gramoxon Toxicity -A case report-)

  • 정진악;금동윤;이재원
    • Journal of Chest Surgery
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    • 제33권9호
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    • pp.773-776
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    • 2000
  • Accidental or suicidal fatalities of paraquat(Gramoxon) poisong are occasionally seen in the emergency room or intensive care unit in this country. In most cases, respiratory symptoms and eventual death by respiratory distress occur within several days. The most striking pathologic change is fibrosis of the lung due to widespread proliferation of fibroblastic cell. We experience a 21-year-old woman with huge bulla on left lung and diffuse fibrosis in other site, who ingested paraquat 10 months ago. After thoracoscopic removal of bulla, the patient survive without progression of pulmonary complication till now.

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특발성 간질성 폐렴 환자의 기관지 폐포 세척액 내의 Clara Cell Secretory Protein 발현에 대한 연구 (The Expression of Clara Cell Secretory Protein in BAL Fluid of Patients with Idiopathic Interstitial Pneumonia)

  • 엄상원;한선진;최창민;이창훈;유철규;이춘택;한성구;심영수;김영환
    • Tuberculosis and Respiratory Diseases
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    • 제53권2호
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    • pp.127-135
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    • 2002
  • 배 경 :특발성 간질성 폐렴은 만성적 염증과 폐 섬유화가 특징적인 병이다. clara cell 10 kD protein(CC10)은 기관지 상피세포에서 만들어지는 강력한 항염 작용을 가진 것으로 알려진 단백질이다. 따라서, CC-10은 특발성 간질성 폐렴 환자의 염증 조절자로서의 역할을 기대할 수 있다. 본 연구에서는 폐 섬유화의 정도와 기관지 폐포 세척액 내의 CC-10 발현 사이의 연관성을 알아 보고자 하였다. 방 법 : 29명의 환자와 10명의 대조군에서 기관지 폐포 세척이 시행되었으며, 세척액을 이용하여, 정량적 Western blot 분석을 시행하였다. 각각의 band의 RI (relative intensity)를 산출하여, 환자의 진단, 기관지 폐포 세척액 내의 염증 세포 분율, 방사선학적 폐 섬유화의 정도와 비교하였다. 결과 : 환자군 ($77.5{\pm}75.8%$)과 대조군 ($70.7{\pm}39.8%$)의 RI 값에는 유의한 차이가 없었다 (p>0.05). 그리고, 통상형 간질성 폐렴 환자의 폐섬유화의 정도 및 기관지 폐포 세척 액 내의 염증 세포 분율에 따라서도 RI 값에 유의한 차이가 없었다 (p>0.05). 결 론: 통상형 간질성 폐렴 환자의 폐 섬유화 정도와 기관지 폐포 세척 액내의 CC-10 농도는 관련이 없다.