Correlation between the Clinical, Etiological, Radiological, and Histopathological Pattern in Patients of Interstitial Lung Disease

Abstract

Abstract Background and Objective: Interstitial lung diseases (ILDs) include a large number of conditions that primarily involve space between the alveolar epithelium, the capillary endothelium, and adjoining structures such as alveoli and small airways. This study has been conceived to generate the data on the clinical, etiological, radiological, and histopathological pattern of patients of ILD. Methods: This prospective study was conducted from January 1, 2018 to October 31, 2019 enrolling 43 patients of ILD who presented as outpatient/in patients to a tertiary care hospital in North India. Based on the clinical presentation and chest X-ray, the suspected patients were subjected to high-resolution computerised tomography (HRCT) chest and pulmonary function test for confirmation. The confirmed cases were then subjected to bronchoscopy and histopathological study. Results: There were 26 (60%) male patients and 17 (40%) female patients in the study population. The mean (±standard deviation) age was 56.9 ± 13.02 years. A diagnosis of ILD was made based on the history and clinical findings in 35 (81.5%) cases. The most common finding on chest radiography was reticular opacities in 20 (46%). Usual interstitial pneumonia pattern 20 (46%) was the most common abnormality on HRCT. Etiological profile was mainly found to be idiopathic pulmonary fibrosis in 19 (45%). Clinicoradiological correlation was seen in 35 cases, clinicohistological in 23 cases, and historadiological in 28 cases. Overall correlation between all the three modalities was established in 20 (46%) cases. Conclusion: The clinical suspicion of ILD is very important due to the varied etiologies and diseases with similar clinical presentations. Given the limitations of chest radiography, HRCT chest is the best noninvasive modality, while bronchoscopy is the most useful minimally invasive investigation tool to establish a diagnosis. Hence, multidisciplinary correlation is the best approach to evaluate a case of interstitial lung disease.