title: Smoking-related interstitial fibrosis combined with pulmonary emphysema: computed tomography-pathologic correlative study using lobectomy specimens.
abstract: OBJECTIVE
  To evaluate the incidence and pathologic correlation of thin-section computed tomography (TSCT) findings in smoking-related interstitial fibrosis (SRIF) with pulmonary emphysema.
  
  
  METHODS
  Our study included 172 consecutive patients who underwent TSCT and subsequent lobectomy. TSCT findings including clustered cysts with visible walls (CCVW) and ground-glass attenuation with/without reticulation (GGAR) were evaluated and compared in nonsmokers and smokers and among lung locations. TSCT findings, especially CCVW, were also compared with histological findings using lobectomy specimens.
  
  
  RESULTS
  The incidence of CCVW and GGAR was significantly higher in smokers than in nonsmokers (34.1% and 40.7%, respectively, vs 2.0% and 12.2%). CCVW and GGAR were frequently found in the lower and peripheral zones. Histologically, CCVW corresponded more often with SRIF with emphysema than usual interstitial pneumonia (UIP, 63.3% vs 30%). CCVW of irregular size and shape were seen in 19 of 20 SRIF with emphysema and in seven of nine UIP-manifested areas with similar round cysts. A less-involved subpleural parenchyma was observed more frequently in SRIF with emphysema.
  
  
  CONCLUSIONS
  SRIF with emphysema is a more frequent pathological finding than UIP in patients with CCVW on TSCT. The irregular size and shape of CCVW and a less-involved subpleural parenchyma may be a clue suggesting the presence of SRIF with emphysema.
authors.affiliation: Department of Radiology, Shiga University of Medical Science, Setatsukinowa-cho, Otsu, Shiga.
authors.forename: Hideji
authors.initials: H
authors.lastname: Otani
authors.affiliation: Department of Pathology, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto, Nagasaki.
authors.forename: Tomonori
authors.initials: T
authors.lastname: Tanaka
authors.affiliation: Department of Radiology, Shiga University of Medical Science, Setatsukinowa-cho, Otsu, Shiga.
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Murata
authors.affiliation: Department of Pathology, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto, Nagasaki.
authors.forename: Junya
authors.initials: J
authors.lastname: Fukuoka
authors.affiliation: Department of Radiology, Shiga University of Medical Science, Setatsukinowa-cho, Otsu, Shiga.
authors.forename: Norihisa
authors.initials: N
authors.lastname: Nitta
authors.affiliation: Department of Radiology, Shiga University of Medical Science, Setatsukinowa-cho, Otsu, Shiga.
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Nagatani
authors.affiliation: Department of Radiology, Shiga University of Medical Science, Setatsukinowa-cho, Otsu, Shiga.
authors.forename: Akinaga
authors.initials: A
authors.lastname: Sonoda
authors.affiliation: Department of Radiology, Yujin-Yamazaki Hospital, Takegahana-cho, Hikone, Shiga, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Takahashi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D003560:Cysts / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008168:Lung / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D017563:Lung Diseases, Interstitial / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy; D011237:Predictive Value of Tests; D011656:Pulmonary Emphysema / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000473:pathology / Q000601:surgery; D011658:Pulmonary Fibrosis / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000473:pathology / Q000601:surgery; D012189:Retrospective Studies; D012907:Smoking / Q000009:adverse effects*; D014057:Tomography, X-Ray Computed
keywords: airspace enlargement with fibrosis; honeycombing; pulmonary emphysema; smoking; smoking-related interstitial fibrosis; usual interstitial pneumonia