Nonspecific interstitial pneumonia: histologic correlation with high-resolution CT in 29 patients.
OBJECTIVE
To determine the pathological correlation with various high-resolution CT (HRCT) findings in cases with nonspecific interstitial pneumonia (NSIP), paying special attention to pathological subgroups.


METHODS
The study involved 29 patients diagnosed with NSIP by surgical lung biopsy. A total of 54 specimens were obtained and grouped according to Katzenstein's classification (groups 1-3) for NSIP. Two observers then evaluated the HRCT findings for every biopsy site and classified the findings according to the main pattern evident into the following four radiologic pattern groups: A, ground-glass attenuation and fine reticulation; B, ground-glass and coarse reticulation; C, consolidation and D, ground-glass attenuation and consolidation.


RESULTS
The pathological pattern was NSIP group 1 in 6 patients, group 2 in 22 and group 3 in 25, while 1 specimen was normal. The main HRCT pattern was pattern A in 15 specimens, B in 8, C in 9 and D in 21. Although there were no significant correlation between HRCT patterns and histological subgroups (Chi-square test, p=0.07), pattern C was more frequently seen in group 2 (7 of 9) and pattern A was more common in group 3 (11 of 15). HRCT pattern A corresponded pathologically to areas of thickened alveolar septa with temporal uniformity. Pattern B correlated with areas with airspace enlargement/emphysema or dilation of small airways superimposed on thickened alveolar septa. Pattern C was pathologically associated with areas of severe thickened alveolar septa, mucin stasis in the small airways and intraluminal organization.


CONCLUSIONS
The pathological backgrounds of the same CT findings in patients with NSIP varied among all pathological subgroups. Areas of ground-glass attenuation and air-space consolidation did not always correspond to reversible pathological findings.
Sumikawa
Hiromitsu
H
Department of Radiology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0825, Japan. h-sumikawa@radiol.med.osaka-u.ac.jp
Johkoh
Takeshi
T
Ichikado
Kazuya
K
Taniguchi
Hiroyuki
H
Kondoh
Yasuhiro
Y
Fujimoto
Kiminori
K
Yanagawa
Masahiro
M
Inoue
Atsuo
A
Mihara
Naoki
N
Honda
Osamu
O
Tomiyama
Noriyuki
N
Nakamura
Hironobu
H
Colby
Thomas V
TV
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D017563:Lung Diseases, Interstitial / Q000000981:diagnostic imaging* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013223:Statistics as Topic; D014057:Tomography, X-Ray Computed / Q000379:methods*