Navegando por Palavras-chave "Pulmonary fibrosis"
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- ItemAcesso aberto (Open Access)Achados histológicos e sobrevida na fibrose pulmonar idiopática(Sociedade Brasileira de Pneumologia e Tisiologia, 2003-12-01) Coletta, Ester Nei Aparecida Martins [UNIFESP]; Pereira, Carlos Alberto de Castro [UNIFESP]; Ferreira, Rimarcs Gomes [UNIFESP]; Rubin, Adalberto Sperb; Villela, Lucimara Sonja; Nunes, Tatiana Santos Malheiros [UNIFESP]; Stávale, João Norberto [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); HSPE Departamento de Patologia; HSPE Departamento de Doenças do Aparelho Respiratório; Sociedade Brasileira de Pneumologia e Tisiologia; Santa Casa Pavilhão Pereira FilhoBACKGROUND: Idiopathic pulmonary fibrosis was recently redefined as usual interstitial pneumonia of unknown etiology. Consequently, the prognostic value of histological findings needs to be reassessed. OBJECTIVE: To correlate clinical, functional and histological findings with survival in patients with idiopathic pulmonary fibrosis. METHOD: Patients (n = 51; mean age: 66 ± 8 years; gender: 21 females/30 males) were evaluated. Of the 51, 26 were smokers or ex-smokers. Duration of symptoms, forced vital capacity and smoking habits were recorded. All patients presented usual interstitial pneumonia verified through histology. Degree of honeycombing, established fibrosis, desquamation, cellularity, myointimal thickening of blood vessels and number of fibroblastic foci were graded according to the semiquantitative method. RESULTS: Median duration of symptoms was 12 months and initial forced vital capacity was 72 ± 21%. Cox multivariate analysis revealed that survival correlated inversely and significantly (p < 0.05) with duration of symptoms and fibroblastic foci score, as well as with myointimal thickening of blood vessels. Limited numbers of fibroblastic foci, as well as myointimal thickening involving less than 50% of blood vessels, were predictive of greater survival. No correlation with survival was found for gender, age, forced vital capacity, inflammation or degree of cellularity. CONCLUSION: Semiquantitative analysis of lung biopsies yields relevant prognostic information regarding patients with usual interstitial pneumonia.
- ItemAcesso aberto (Open Access)Airway-centered interstitial fibrosis: etiology, clinical findings and prognosis(Biomed Central Ltd, 2015-05-09) Kuranishi, Lilian Tiemi [UNIFESP]; Leslie, Kevin O.; Ferreira, Rimarcs Gomes [UNIFESP]; Coletta, Ester Aparecida Ney [UNIFESP]; Storrer, Karin Mueller [UNIFESP]; Soares, Maria Raquel [UNIFESP]; Pereira, Carlos Alberto de Castro [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Mayo ClinBackground: Airway-centered Interstitial Fibrosis (ACIF) is a common pathologic pattern observed in our practice.Objectives: the objectives of this study are to describe the causes associated with ACIF in a large sample of patients and its effect on survival.Methods: A retrospective study in three centers of interstitial lung disease in São Paulo, between January of 1995 and December of 2012. the surgical lung biopsy specimens were reviewed by three pathologists. the clinical, functional and tomographic findings were analyzed by a standardized protocol.Results: There were 68 cases of ACIF, most of them women. the mean age was 57 +/- 12 yr. Dyspnea, cough, restrictive pattern at spirometry and oxygen desaturation at exercise were common. A reticular pattern with peribronchovascular infiltrates was found in 79% of the cases. the etiologies of ACIF were hypersensitivity pneumonitis in 29 (42.6%), gastroesophageal reflux disease in 17 (25.0%), collagen vascular disease in 4 (5.9%), a combination of them in 15 cases and idiopathic in 3 (4.4%). the median survival was 116 months (95% CI = 58.5 - 173.5). Lower values of oxygen saturation at rest, presence of cough and some histological findings - organizing tissue in the airways, fibroblastic foci and microscopic honeycombing - were predictors of worse survival.Conclusions: ACIF is an interstitial lung disease with a better survival when compared with IPF. the main etiologies are HP and GERD. the oxygen saturation at rest, the presence of cough and some histological findings are predictors of survival.
- ItemAcesso aberto (Open Access)Análise semiquantitativa de biópsias cirúrgicas de diferentes lobos pulmonares de pacientes com pneumonia intersticial usual/fibrose pulmonar idiopática(Sociedade Brasileira de Pneumologia e Tisiologia, 2009-07-01) Gonçalves, José Júlio Saraiva; Leao, Luiz Eduardo Villaca [UNIFESP]; Ferreira, Rimarcs Gomes [UNIFESP]; Oliveira, Renato [UNIFESP]; Ota, Luiz Hirotoshi [UNIFESP]; Santos, Ricardo Sales Dos; Universidade para o Desenvolvimento do Estado e da Região do Pantanal; Universidade Federal de São Paulo (UNIFESP); Boston University School of MedicineOBJECTIVE: To evaluate the differences between surgical biopsies of distinct lung lobes in terms of the histopathological features of usual interstitial pneumonia, using a semiquantitative score. METHODS: We selected all of the patients diagnosed with idiopathic pulmonary fibrosis and submitted to surgical biopsy in two distinct lobes between 1995 and 2005 at the Hospital São Paulo and other hospitals operated by the Federal University of São Paulo. In the histological evaluation of the specimens, we used a semiquantitative method based on previous studies, assigning a score to each of the biopsied sites. RESULTS: In this sample of patients, we found no statistically significant differences that would alter the stage of the disease, based on the score used. This finding was independent of the biopsy site (middle lobe or lingular segment). CONCLUSIONS: No significant histological differences were found between the lung lobes studied. The definitive histological diagnosis of usual interstitial pneumonia did not alter the stage of the disease.
- ItemAcesso aberto (Open Access)Ossificação pulmonar dendriforme(Sociedade Brasileira de Pneumologia e Tisiologia, 2006-06-01) Duarte, Andrezza Araújo De Oliveira; Nakatani, Jorge [UNIFESP]; Rigueiro, Moacyr Pezati [UNIFESP]; Saad, Tânia; Hospital Santa Marcelina; Universidade Federal de São Paulo (UNIFESP)Diffuse pulmonary ossification is a rare condition of unknown pathogenesis in which mature bone is found in the pulmonary parenchyma. It is almost invariably discovered as an incidental finding at autopsy. Most commonly, it affects middle-aged men and is asymptomatic. We present the case of a 75-year-old man in which the chest X-ray showed diffuse interstitial infiltrate. Diagnosis was based on histopathological examination by open-lung biopsy, which revealed interstitial fibrosis with pulmonary ossification.