Clinical Course and Changes in High-Resolution Computed Tomography Findings in Patients with Idiopathic Pulmonary Fibrosis without Honeycombing.
Some patients with idiopathic pulmonary fibrosis (IPF) do not have honeycombing on high-resolution computed tomography (HRCT) at their initial evaluation. The clinical course and sequential changes in HRCT findings in these patients are not fully understood. We reviewed the cases of 43 patients with IPF without honeycombing on initial HRCT from institutions throughout Japan. All patients were diagnosed with IPF based on a surgical lung biopsy. Multidisciplinary discussions were held five times between 2011 and 2014, to exclude alternative etiologies. We evaluated the sequential changes in HRCT findings in 30 patients with IPF. We classified these 30 patients into three groups based on their HRCT patterns and clarified the clinical characteristics and prognosis among the groups. The patterns of all 30 patients on initial HRCT corresponded to a possible usual interstitial pneumonia (UIP) pattern which was described in the 2011 International Statement. On long-term follow-up (71.0±38.7 standard deviation [SD] months), honeycombing was seen in 16 patients (53%, the HoneyCo group); traction bronchiectasis or cysts without honeycombing was observed in 12 patients (40%, the NoHoneyCo group), and two patients showed no interval change (7%, the NoChange group) on HRCT. The mean survival periods of the HoneyCo and NoHoneyCo groups were 67.1 and 61.2 months, respectively (p = 0.76). There are some patients with IPF whose conditions chronically progress without honeycombing on HRCT. The appearance of honeycombing on HRCT during the follow-up might not be related to prognosis.
Department of Medicine, Jichi Medical University, Tochigi, Japan.
Hiroyoshi
http://orcid.org/0000-0003-4043-4332
H
Yamauchi
Department of Medicine, Jichi Medical University, Tochigi, Japan.
Masashi
M
Bando
Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, Kanagawa, Japan.
Tomohisa
T
Baba
Department of Respiratory Medicine and Allergy, Tosei General Hospital, Aichi, Japan.
Kensuke
K
Kataoka
Department of Respiratory Medicine, JR Tokyo General Hospital, East Japan Railway Company, Tokyo, Japan.
Yoshihito
Y
Yamada
First Department of Internal Medicine, Shinshu University School of Medicine, Nagano, Japan.
Hiroshi
H
Yamamoto
Department of Respiratory Medicine, Toranomon Hospital, Tokyo, Japan.
Atsushi
A
Miyamoto
Department of Respiratory Medicine, Japanese Red Cross Medical Center, Tokyo, Japan.
Soichiro
S
Ikushima
Department of Radiology, Kinki Central Hospital of Mutual Aid Association of Public School Teachers, Hyogo, Japan.
Takeshi
T
Johkoh
Department of Diagnostic Radiology, Saitama Medical University International Medical Center, Saitama, Japan.
Fumikazu
F
Sakai
Department of Analytic Human Pathology, Nippon Medical School, Tokyo, Japan.
Yasuhiro
Y
Terasaki
Department of Clinical Research, National Hospital Organization Tokyo National Hospital, Tokyo, Japan.
Akira
A
Hebisawa
Division of Diagnostic Pathology, Saitama Prefectural Cardiovascular and Respiratory Center, Saitama, Japan.
Yoshinori
Y
Kawabata
Department of Medicine, Jichi Medical University, Tochigi, Japan.
Yukihiko
Y
Sugiyama
Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, Kanagawa, Japan.
Takashi
T
Ogura
D000368:Aged; D018450:Disease Progression; D005260:Female; D006801:Humans; D054990:Idiopathic Pulmonary Fibrosis / Q000000981:diagnostic imaging / Q000473:pathology*; D008168:Lung / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed