Computed tomography findings of current nonspecific interstitial pneumonia based on the 2013 updated classification of i
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ORIGINAL ARTICLE
Computed tomography findings of current nonspecific interstitial pneumonia based on the 2013 updated classification of idiopathic interstitial pneumonias: What is a characteristic of previously diagnosed nonspecific interstitial pneumonia excluded from the updated classification Junya Tominaga1 · Tae Iwasawa2 · Makiko Murota3 · Hiroaki Arakawa4 · Takeshi Johkoh5 · Yasuhiko Yamano6 · Yoshiaki Zaizen7 · Kazuya Ichikado8 · Mikiko Hashisako9 · Yasuhiro Kondoh6 · Kensuke Kataoka6 · Masaki Okamoto10 · Kiminori Fujimoto11 · Junya Fukuoka7 · on behalf of the Study Group of Creation of Radiological Paper from Japan in Diffuse Lung Disease Received: 24 May 2020 / Accepted: 21 August 2020 © Japan Radiological Society 2020
Abstract Purpose To evaluate computed tomography (CT) findings of nonspecific interstitial pneumonia (NSIP) based on the current classification of idiopathic interstitial pneumonias (IIPs) and elucidate a characteristic of previously diagnosed NSIP excluded from the current classification. Materials and methods The study included 74 patients with biopsy-proven NSIP (idiopathic NSIP [I-NSIP], 39 patients; NSIP associated with connective tissue disease [CTD-NSIP], 35 patients). Among patients who were compatible with the current classification of IIPs, 29 and 21 were categorized as having current I-NSIP and current CTD-NSIP, respectively. The remaining 24 patients were categorized as having previous I-NSIP or previous CTD-NSIP due to the primary pathologic diagnosis of cellular NSIP or associated findings of acute inflammatory changes. CT findings were evaluated and compared among the four groups. Results Current I-NSIP was indicated by ground-glass attenuation and reticulation with traction bronchiectasis/bronchiolectasis in predominantly peribronchovascular areas of the lower lung zone. The previous I-NSIP group tended to show broader airspace consolidation than the current I-NSIP group (p = 0.068). The previous CTD-NSIP group showed significantly broader airspace consolidation than the current I-NSIP group (p = 0.035). Conclusion Broad airspace consolidation is a characteristic of previously diagnosed CTD-NSIP excluded from the current classification of IIPs. Keywords Chronic fibrosing interstitial pneumonia · Nonspecific interstitial pneumonia · Computed tomography
Introduction In 1994, Katzenstein and Fiorelli reported 64 cases of interstitial pneumonia that could not be classified into any specific category of idiopathic interstitial pneumonias (IIPs). At that time, these cases were termed nonspecific interstitial pneumonia (NSIP). They showed that NSIP represented
* Junya Tominaga [email protected]‑net.ne.jp Extended author information available on the last page of the article
various pathologic findings of interstitial inflammation and fibrosis on pathologic analysis [1]. Subsequently, NSIP was provisionally included in the American Thoracic Society/ European Respiratory Society (ATS/ERS) classification of IIPs in 2002 (the previous classification of IIPs) [2]. Thereafter, a seri
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