• 제목/요약/키워드: interstitial pulmonary disease

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Korean Guidelines for Diagnosis and Management of Interstitial Lung Diseases: Part 2. Idiopathic Pulmonary Fibrosis

  • Lee, Sang Hoon;Yeo, Yoomi;Kim, Tae-Hyung;Lee, Hong Lyeol;Lee, Jin Hwa;Park, Yong Bum;Park, Jong Sun;Kim, Yee Hyung;Song, Jin Woo;Jhun, Byung Woo;Kim, Hyun Jung;Park, Jinkyeong;Uh, Soo-Taek;Kim, Young Whan;Kim, Dong Soon;Park, Moo Suk;Korean Interstitial Lung Diseases Study Group
    • Tuberculosis and Respiratory Diseases
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    • 제82권2호
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    • pp.102-117
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    • 2019
  • Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive fibrosing interstitial pneumonia, which presents with a progressive worsening dyspnea, and thus a poor outcome. The members of the Korean Academy of Tuberculosis and Respiratory Diseases as well as the participating members of the Korea Interstitial Lung Disease Study Group drafted this clinical practice guideline for IPF management. This guideline includes a wide range of topics, including the epidemiology, pathogenesis, risk factors, clinical features, diagnosis, treatment, prognosis, and acute exacerbation of IPF in Korea. Additionally, we suggested the PICO for the use of pirfenidone and nintendanib and for lung transplantation for the treatment of patients with IPF through a systemic literature review using experts' help in conducting a meta-analysis. We recommend this guideline to physicians, other health care professionals, and government personnel in Korea, to facilitate the treatment of patients with IPF.

폐포단백증 1예 (A Case of Pulmonary Alveolar Proteinosis)

  • 우대형;박정은;류영하;김현정;신경철;정진홍;이관호
    • Journal of Yeungnam Medical Science
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    • 제27권1호
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    • pp.57-62
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    • 2010
  • Pulmonary alveolar proteinosis (PAP) is a rare disorder that's characterized by accumulation of surfactant components in the alveolar space. Idiopathic PAP is recognized as an autoimmune disease that's due to impaired alveolar macrophage function and this caused by autoantibodies against granulocyte-macrophage colony-stimulating factor (GM-CSF). We report here a case of pulmonary alveolar proteinosis that was deemed interstitial lung disease at the initial diagnosis. A 61-year-old man presented with intermittent blood tinged sputum and dyspnea on exertion. The man was a painter for 30 years and he had a 10 pack-years smoking history. Chest computerized tomography (CT) revealed multifocal ground-glass opacity with interstitial thickening at both lungs. His pulmonary function tests and methacholine test revealed non specific results. He was diagnosed with interstitial lung disease on the basis of the chest CT finding and occupational history. However, seven months later, his symptoms progressed. Follow-up chest CT was performed. Wedge resection via video-assisted thoracoscopic surgery (the anterior basal segment of the left lower lobe) was done. Microscopic examination showed large groups of alveoli with excessive amounts of surfactant and a complex mixture of protein and lipid (fat) molecules. Finally, he was diagnosed as having pulmonary alveolar proteinosis.

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특발폐섬유증 진단의 최신 지견과 간질성폐이상 (Update in Diagnosis of Idiopathic Pulmonary Fibrosis and Interstitial Lung Abnormality)

  • 남보다;황정화
    • 대한영상의학회지
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    • 제82권4호
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    • pp.770-790
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    • 2021
  • 최신 국제 임상진료지침을 기반으로 한 특발폐섬유증의 진단은 부합하는 임상 소견과 함께 고해상 CT에서 전형적인 상용간질폐렴 소견을 보일 때 조직학적 폐 생검 없이 진단 가능하다. 영상 검사는 특발폐섬유증의 평가 및 진단에 중추적인 역할을 하며, 정확한 진단을 위하여 임상적, 영상의학적 및 병리학적 소견에 대한 다학제 검토의 중요성이 강조된다. 간질성폐이상(interstitial lung abnormality)은 우연히 발견된 영상의학적 이상 소견을 지칭하며, 간질성폐이상과 임상적으로 의미 있는 간질폐질환에 대한 구분은 적절한 임상 평가를 기반으로 이루어져야 한다. 저자들은 이번 종설을 통하여 특발폐섬유증 진단의 최신 지견 및 간질성폐이상에 대한 이해를 도움으로써 미만성 간질폐섬유증 환자의 정확한 진단과 치료 및 예후 증진에 도움이 되고자 한다.

침습성 폐 아스페르길루스증을 동반한 급성 간질성 폐렴 1예 (A Case of Acute Interstitial Pneumonia with Invasive Pulmonary Aspergillosis)

  • 이영민;윤혜경;김주인
    • Tuberculosis and Respiratory Diseases
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    • 제52권1호
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    • pp.62-69
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    • 2002
  • 저자들은 호흡곤란을 주소로 내원한 환자에서 미만성 간질성 폐질환 의심하에 고용량의 부신 피질 호르몬제 투여도중 폐병변 악화로 흉강경을 이용한 폐생검을 실시하여 침습성 폐 아스페르길루스증을 동반한 급성 간질성 폐렴을 경험하였기에 문헌고찰과 함께 보고하는 바이다.

Multiple Cancers in a Patient with Systemic Sclerosis and Aggravated Interstitial Lung Disease by Chemotherapy

  • Park, Chan Kwon;Lee, Seok Jong;Cho, Hyung Jun;Lee, Kyeong Soo;Kim, Sung Jun;Cho, Gu Min;Lee, Ha Ni
    • Tuberculosis and Respiratory Diseases
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    • 제75권3호
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    • pp.111-115
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    • 2013
  • Although the relationship between malignancy risk with systemic sclerosis (SSc) has been inconclusive, there are some previous studies for a positive correlation. Most patients with SSc have some degree of lung parenchymal involvement in the form of interstitial thickening and fibrosis. Interstitial lung disease is the most common pulmonary manifestation of SSc. Interstitial lung disease following chemotherapy (5-fluorouracil, leucovorin, and oxaliplatin [FOLFOX]) is an uncommon life-threatening complication and it is induced by oxaliplatin. We report a case of multiple cancers in a patient with SSc and aggravated interstitial lung disease by chemotherapy.

Usefulness of Temporal Subtraction for The Detection of Interval Changes of Interstitial Lung Diseases on Chest Radiographs

  • Higashida, Yoshiharu;Ideguchi, Tadamitsu;Muranaka, Toru;Akazawa, Fumio;Miyajima, Ryuichi;Tabata, Nobuyuki;Ikeda, Hirotaka;Ohki, Masafumi;Toyofuku, Fukai;Doi, Kunio
    • 한국의학물리학회:학술대회논문집
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    • 한국의학물리학회 2002년도 Proceedings
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    • pp.454-456
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    • 2002
  • The evaluation of interval changes between temporally sequential chest radiographs is necessary for the detection of new abnormalities or interval changes, such as pulmonary nodules and interstitial disease. For interstitial lung disease, the interval changes are very important for diagnosis and treatment. Especially, interstitial lung disease may show rapid changes in the radiographs, show changes in the entire lung field in minute detail, or show changes in multiple parts depending on the type. It is therefore difficult to have an accurate grasp of the condition of the disease only with conventional radiographs. The temporal subtraction technique which was developed at the University of Chicago, provides a subtraction image of the current warped image and the previous image. A temporal subtraction image, shows only differences and changes between the two images, can be very useful for a diagnosis of interstitial lung disease. However, the evaluation of the temporal subtraction technique for interstitial lung disease using receiver operating characteristic(ROC) studies has not been reported yet. Therefore, we have evaluated the clinical usefulness of a temporal subtraction technique for detection of interval changes of interstitial lung disease by ROC analysis.

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거대세포 간절성 폐렴(Giant Cell Interstitial Pneumonia) 1예 (A Case of Giant Cell Interstitial Pneumonia)

  • 강경우;박상준;서지영;한정호;정만표;김호중;권오정;이종헌;최재욱
    • Tuberculosis and Respiratory Diseases
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    • 제48권2호
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    • pp.260-267
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    • 2000
  • 거대세포성 간질성 폐렴은 경금속 도구를 이용한 절삭, 연마공정에서 발생하는 경금속 분진을 흡입하여 발생하는 산업성 폐질환으로 알려져 있다. 저자들은 이러한 특징적인 경금속분진에 대한 노출력이 없이 발생하였던 거대세포성 간질성 폐렴을 수술적 폐생검과 폐조직내 금속 함유량 분석을 통해 진단하였기에 보고 하는 바이다.

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Pathological interpretation of connective tissue disease-associated lung diseases

  • Kwon, Kun Young
    • Journal of Yeungnam Medical Science
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    • 제36권1호
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    • pp.8-15
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    • 2019
  • Connective tissue diseases (CTDs) can affect all compartments of the lungs, including airways, alveoli, interstitium, vessels, and pleura. CTD-associated lung diseases (CTD-LDs) may present as diffuse lung disease or as focal lesions, and there is significant heterogeneity between the individual CTDs in their clinical and pathological manifestations. CTD-LDs may presage the clinical diagnosis a primary CTD, or it may develop in the context of an established CTD diagnosis. CTD-LDs reveal acute, chronic or mixed pattern of lung and pleural manifestations. Histopathological findings of diverse morphological changes can be present in CTD-LDs airway lesions (chronic bronchitis/bronchiolitis, follicular bronchiolitis, etc.), interstitial lung diseases (nonspecific interstitial pneumonia/fibrosis, usual interstitial pneumonia, lymphocytic interstitial pneumonia, diffuse alveolar damage, and organizing pneumonia), pleural changes (acute fibrinous or chronic fibrous pleuritis), and vascular changes (vasculitis, capillaritis, pulmonary hemorrhage, etc.). CTD patients can be exposed to various infectious diseases when taking immunosuppressive drugs. Histopathological patterns of CTD-LDs are generally nonspecific, and other diseases that can cause similar lesions in the lungs must be considered before the diagnosis of CTD-LDs. A multidisciplinary team involving pathologists, clinicians, and radiologists can adequately make a proper diagnosis of CTD-LDs.

Intralobar Pulmonary Sequestration Showing Increased Serum CA19-9

  • Ahn, Yong-Hwan;Song, Mi-Jin;Park, Sang-Hyun
    • Tuberculosis and Respiratory Diseases
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    • 제72권6호
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    • pp.507-510
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    • 2012
  • Carbohydrate antigen 19-9 (CA19-9) is a specific tumor marker of the biliary, pancreatic and gastrointestinal tracts. CA19-9 is occasionally elevated in serum in patiens with benign pulmonary diseases such as bronchiectasis, idiopathic interstitial pneumonia or collagen disease-associated pulmonary fibrosis. Intralobar pulmonary sequestration is an uncommon congenital lung anomaly. It is dissociated from the normal tracheobronchial tree and is supplied by an anomalous systemic artery. There have been some reports of elevation of CA19-9 in this lesion. We report a case of intralobar pulmonary sequestration with elevated serum CA19-9 in a 29-year-old man who was diagnosed with bronchiectasia of left lower lung field on general check up. He had no evidence of any malignant disease in pancreatobiliary or gastrointestinal tracts. Elevated serum CA19-9 level might be encountered with benign pulmonary disease such as pulmonary sequestration.