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Radiologia brasileira · Mar 2016
High-resolution computed tomography and histopathological findings in hypersensitivity pneumonitis: a pictorial essay.
- Pedro Paulo Teixeira E Silva Torres, Marise Amaral Rebouças Moreira, Daniela Graner Schuwartz Tannus Silva, Roberta Rodrigues Monteiro da Gama, Denis Masashi Sugita, and Maria Auxiliadora do Carmo Moreira.
- MD, Radiologist, Volunteer at the Hospital das Clínicas da Universidade Federal de Goiás (UFG), Radiologist at Clínica Multimagem, Goiânia, GO, Brazil.
- Radiol Bras. 2016 Mar 1; 49 (2): 112-6.
AbstractHypersensitivity 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.
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