Parenchymal opacification in chronic infiltrative lung diseases: CT-pathologic correlation

Area of Science:

• Pulmonary Medicine
• Radiology
• Pathology

Background:

• Chronic infiltrative lung diseases present with diverse parenchymal abnormalities.
• Accurate correlation between imaging and histology is crucial for diagnosis and management.

Purpose of the Study:

• To correlate parenchymal opacification patterns on thin-section computed tomography (CT) with histologic findings in patients with chronic infiltrative lung disease.
• To determine the proportion of potentially treatable disease indicated by CT findings.

Main Methods:

• Retrospective review of thin-section CT scans and open-lung biopsy results in 29 patients with 11 types of chronic infiltrative lung disease.
• Classification of CT findings based on predominant involvement: air space, interstitium, or mixed.
• Assessment of disease activity and fibrosis extent from histologic examination.

Main Results:

• Parenchymal opacification on CT corresponded to air space involvement in 10%, interstitial involvement in 45%, and mixed involvement in 45% of patients.
• In 86% of patients, CT findings were associated with potentially treatable or reversible disease.
• Irreversible abnormalities were noted in patients with end-stage fibrosis and talcosis.

Conclusions:

• Parenchymal opacification on thin-section CT is a nonspecific imaging finding in chronic infiltrative lung diseases.
• CT findings typically indicate potentially treatable or reversible conditions, guiding clinical management.
• Correlation with histology is essential for definitive diagnosis and prognosis assessment.