Evaluation of Radio-Pathologic Correlation in Interstitial Pulmonary Disease Patients

Abstract

Background

The definition of ILD (interstitial lung disease) is diffuse parenchymal lung involvement due to various etiologies.  ILD constitutes 15% of lung diseases.  The first step in diagnosis is history, physical exam and focus on information about work exposure, environment, medications and history of symptoms related to collagen vascular diseases.  Open lung biopsy or video-assisted thoracoscopic biopsy is performed when clinical information and HRCT are not diagnostic.  The purpose of this study was to evaluate radio-pathologic correlation in interstitial lung diseases including sarcoidosis.

Materials and Methods

This was a cross-sectional observational study with chart review of patients with ILD attending our center since HRCT has been used here (since 1999).  HRCT of all patients with ILD who had open lung biopsy was reviewed by radiologist in three steps.  First was the clinico-radiologic report at the time of diagnosis.  Second, after reviewing patient history,  important clinical and paraclinical information (pertinent positives), HRCT was reviewed by single radiologist who was blinded to the initial readings.  Third pathology of the patient was reviewed, giving three diagnoses which were compared with each other.  Predicted diagnoses included UIP/IPF, NSIP, HP, BOOP pattern, and sarcoidosis.  Demographic information was also obtained.

Results

In near 70%, clinicoradiologic diagnosis conferred with pathologic diagnosis and in the remaining 30%, open lung biopsy did not help with specific diagnosis.

Discussion

In our series of 15 patients, it seems that OLB had small place in reaching final diagnosis in ILD patients.

Keywords:Lung Diseases, Interstitial; Radiology; Pathology; Association