Abstract
Aims: Myeloperoxidase anti-neutrophil cytoplasmic antibody-positive interstitial pneumonia (ANCA-IP) commonly have usual interstitial pneumonia (UIP) pattern in radiological and pathological features. Cystic lesions are often seen in the lung with ANCA-IP. The aim of this study is to clarify the histogenesis of cystic lesions in ANCA-IP.
Methods: We retrospectively reviewed 28 ANCA-IP cases with surgical lung biopsy showing cyst or honeycomb in HRCT on the radiological and pathological features and compared with those of idiopathic pulmonary fibrosis (IPF). HRCT and histological patterns were applied with ATS/ERS 2011 guideline.
Results: In 28 ANCA-IP cases, mean age was 68 years with 19 males and smoking history in 14. Ten developed systemic microscopic polyangiitis (MPA) and 18 had lung disease only. In radiological analysis, 6 showed definite, 3 had possible, and 19 had inconsistent with UIP pattern. The presence of extensive pure ground glass opacity was significantly higher in ANCA-IP cases compared with IPF. All the cases developing MPA had inconsistent with UIP pattern. Pathology showed UIP pattern in 20 and NSIP in 4 cases. The extent of inflammatory cell infiltration into the alveolar septum and bronchiolar walls was significantly greater than that of IPF. Cellular and destructive bronchiolitis involving the intralobular bronchioles in ANCA-IP may be related to airspace enlargement and cystic lesions. These cystic lesions resembled UIP pattern in IPF.
Conclusions: Cystic lesions in ANCA-IP may be consequent to inflammatory destruction of the intralobular bronchioles, which is uncommon in honeycomb lesion in IPF.
Footnotes
Cite this article as: European Respiratory Journal 2018 52: Suppl. 62, OA3820.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2018