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2016 ; 49
(2
): 112-6
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High-resolution computed tomography and histopathological findings in
hypersensitivity pneumonitis: a pictorial essay
#MMPMID27141134
Torres PP
; Moreira MA
; Silva DG
; da Gama RR
; Sugita DM
; Moreira MA
Radiol Bras
2016[Mar]; 49
(2
): 112-6
PMID27141134
show ga
Hypersensitivity pneumonitis is a diffuse interstitial and granulomatous lung
disease caused by the inhalation of any one of a number of antigens. The
objective of this study was to illustrate the spectrum of abnormalities in
high-resolution computed tomography and histopathological findings related to
hypersensitivity pneumonitis. We retrospectively evaluated patients who had been
diagnosed with hypersensitivity pneumonitis (on the basis of
clinical-radiological or clinical-radiological-pathological correlations) and had
undergone lung biopsy. Hypersensitivity pneumonitis is clinically divided into
acute, subacute, and chronic forms; high-resolution computed tomography findings
correlate with the time of exposure; and the two occasionally overlap. In the
subacute form, centrilobular micronodules, ground-glass opacities, and air
trapping are characteristic high-resolution computed tomography findings, whereas
histopathology shows lymphocytic inflammatory infiltrates, bronchiolitis,
variable degrees of organizing pneumonia, and giant cells. In the chronic form,
high-resolution computed tomography shows traction bronchiectasis, honeycombing,
and lung fibrosis, the last also being seen in the biopsy sample. A definitive
diagnosis of hypersensitivity pneumonitis can be made only through a
multidisciplinary approach, by correlating clinical findings, exposure history,
high-resolution computed tomography findings, and lung biopsy findings.