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The lung in polyarteritis nodosa: a pathologic study of 10 cases
T Matsumoto1, S Homma, M Okada
1First Department of Pathology, Juntendo University, School of Medicine, Tokyo, Japan.
Human Pathology
|July 1, 1993
Summary
Polyarteritis nodosa (PAN) can affect the lungs, causing arteritis in bronchial arteries and diffuse alveolar damage (DAD). This study highlights that lung involvement and interstitial fibrosis are more common in PAN than previously thought.
Area of Science:
- Pulmonary Pathology
- Rheumatology
- Systemic Vasculitis
Background:
- Polyarteritis nodosa (PAN) is a systemic necrotizing arteritis affecting medium and small arteries.
- Pulmonary involvement and interstitial lung disease were considered rare in PAN.
Purpose of the Study:
- To investigate the prevalence and characteristics of pulmonary pathology in patients with Polyarteritis Nodosa.
- To assess the association between PAN and diffuse alveolar damage (DAD) and interstitial fibrosis.
Main Methods:
- Detailed pathological analysis of pulmonary tissues from 10 autopsy cases of PAN.
- Examination of arteritis in bronchial arteries, diffuse alveolar damage, and interstitial fibrosis.
Main Results:
- Arteritis affecting bronchial arteries was found in 70% of cases.
- Diffuse alveolar damage (DAD) was present in 50% of patients, with varying degrees of interstitial fibrosis, particularly in lower lobes.
- Interstitial fibrosis and honeycomb lung were observed in two patients.
Conclusions:
- Pulmonary arteritis is more common in PAN than previously recognized.
- Diffuse alveolar damage (DAD) and interstitial fibrosis should be considered significant complications of Polyarteritis Nodosa.
- DAD was a cause of respiratory failure in 50% of the studied PAN cases.