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Lilburn P, Pillutla D, Sivasubramaniam V, Plit M. Inescapable Fibrosis: The Development of Desquamative Interstitial Pneumonia Post-Lung Transplantation Performed for a Patient with Idiopathic Pulmonary Fibrosis. Case Rep Transplant 2023; 2023:1737309. [PMID: 37090840 PMCID: PMC10115523 DOI: 10.1155/2023/1737309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 11/18/2022] [Accepted: 02/21/2023] [Indexed: 04/25/2023] Open
Abstract
Interstitial lung disease is characterised by a combination of cellular proliferation, inflammation of the interstitium and fibrosis within the alveolar wall. A 58-year-old man was referred for lung transplantation after developing worsening dyspnoea and progressive hypoxaemic respiratory failure from idiopathic pulmonary fibrosis. Three years later, he developed desquamative interstitial pneumonia in his transplanted lungs, and despite augmentation of immune suppression, he had a progressive decline in his lung function and exercise capacity. Interestingly, in our case, the histopathology obtained post transplant strongly goes against the recurrence of usual interstitial pneumonia/idiopathic pulmonary fibrosis; rather, two separate interstitial disease processes have been identified.
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Affiliation(s)
- Paul Lilburn
- University of New South Wales, Kensington, NSW 2052, Australia
- Macquarie University Hospital, 3 Technology Place, North Ryde, NSW 2109, Australia
- Department of Respiratory Medicine, Prince of Wales Hospital, Randwick, NSW 2031, Australia
| | - Divya Pillutla
- St. Vincent's Hospital, 390 Victoria Street, Darlinghurst, NSW 2010, Australia
| | - Vanathi Sivasubramaniam
- University of New South Wales, Kensington, NSW 2052, Australia
- St. Vincent's Hospital, 390 Victoria Street, Darlinghurst, NSW 2010, Australia
| | - Marshall Plit
- University of New South Wales, Kensington, NSW 2052, Australia
- St. Vincent's Hospital, 390 Victoria Street, Darlinghurst, NSW 2010, Australia
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Zhao JG, Zhou GW, Zhao L, Liu M, Ren YH, Dai HP. Safety and accuracy of transbronchial lung cryobiopsy in diagnosing desquamative interstitial pneumonia. THE CLINICAL RESPIRATORY JOURNAL 2022; 16:309-316. [PMID: 35229474 PMCID: PMC9060098 DOI: 10.1111/crj.13483] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 11/01/2021] [Accepted: 02/07/2022] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Transbronchial lung cryobiopsy (TBLC) is a new technique to obtain specimens for diagnosis of interstitial lung disease (ILD) in recent years. The objective of this study is to evaluate the safety and the diagnostic accuracy of TBLC in patients of desquamative interstitial pneumonia (DIP). METHODS In this study twelve patients confirmed with DIP were selected from January 2019 to December 2020 at the department of pulmonary and critical care medicine in China-Japan Friendship Hospital. All cases underwent TBLC in a hybrid cone beam CT (CBCT) operation room with a single general anesthesia. The definitive diagnosis was made by a multidisciplinary team that involved clinicians, radiologists and pathologists. This study analyzed the biopsy sample surface areas, main complications and the consistency between TBLC pathology and multidisciplinary discussion (MDD) diagnosis for DIP. RESULTS An average of 3.1 ± 1.1 specimens were obtained per patient. The mean surface area of the specimen was 23.7 ± 6.1 mm2 . None of the cases had pneumothorax or massive hemorrhage. Ten cases (83.3%) had no or mild bleeding and two cases (16.7%) had moderate bleeding. All cases had the typical pathologic characteristics of DIP, which was highly consistent with the diagnosis of MDD. CONCLUSION TBLC can obtain sufficient samples for the pathological diagnosis of DIP, which has high security and accuracy in experienced specialist centers.
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Affiliation(s)
- Jun-Ge Zhao
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital; National Clinical Research Center for Respiratory Diseases, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China.,Department of Pulmonary and Critical Care Medicine, Zheng-Zhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, China
| | - Guo-Wu Zhou
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital; National Clinical Research Center for Respiratory Diseases, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Ling Zhao
- Department of Pathology, Center of Respiratory Medicine, China-Japan Friendship Hospital; National Clinical Research Center for Respiratory Diseases, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Min Liu
- Department of Radiology, Center of Respiratory Medicine, China-Japan Friendship Hospital; National Clinical Research Center for Respiratory Diseases, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Yan-Hong Ren
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital; National Clinical Research Center for Respiratory Diseases, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Hua-Ping Dai
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital; National Clinical Research Center for Respiratory Diseases, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China
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Ishimoto H, Sakamoto N, Ozasa M, Tsutsui S, Hara A, Kido T, Yamaguchi H, Yamamoto K, Obase Y, Ishimatsu Y, Mukae H. Idiopathic desquamative interstitial pneumonia diagnosed using transbronchial lung cryobiopsy: A case report. Respir Med Case Rep 2021; 34:101523. [PMID: 34692398 PMCID: PMC8515295 DOI: 10.1016/j.rmcr.2021.101523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Revised: 08/27/2021] [Accepted: 09/07/2021] [Indexed: 11/30/2022] Open
Abstract
A 60-year-old Japanese man with a history of heavy smoking came to our hospital for a detailed examination, suspecting interstitial pneumonia because of gradually increasing dyspnea on exertion over a period of one year. Chest high-resolution computed tomography revealed ground-glass shadows with emphysematous changes. Pathological analysis of samples obtained using transbronchial lung cryobiopsy revealed an accumulation of alveolar macrophages with abundant eosinophilic cytoplasm in the alveolar space. Following a multidisciplinary discussion, the patient was diagnosed with desquamative interstitial pneumonia. To our knowledge, this is the first detailed report of desquamative interstitial pneumonia diagnosed using transbronchial lung cryobiopsy.
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Affiliation(s)
- Hiroshi Ishimoto
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Noriho Sakamoto
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Mutsumi Ozasa
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan.,Department of Pathology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Shin Tsutsui
- Department of Radiology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Atsuko Hara
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Takashi Kido
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Hiroyuki Yamaguchi
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Kazuko Yamamoto
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Yasushi Obase
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Yuji Ishimatsu
- Department of Nursing, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8520, Japan
| | - Hiroshi Mukae
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
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