Interstitial Lung Diseases Associated with Connective Tissue Pathologies: Radiologic Features

Houda Gharsalli,Henda Neji,Khaoula Ben Miled-Mrad,Imen Sahnoun,Monia Attia,Sonia Maalej,Sawssen Hantous-Zannad,Leila Douik El Gharbi

doi:10.4236/ojrd.2019.94010

Houda Gharsalli, Henda Neji + Show 6 more

Open Access

https://doi.org/10.4236/ojrd.2019.94010

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Abstract

Introduction: The high resolution computed tomography (HRCT) is an important part in the diagnostic approach of interstitial lung disease (ILD) associated with connective tissue diseases (CTD) by providing detailed information on the elementary lesion and the radiological pattern of ILD. Aim: to point out the role of HRCT in the diagnosis of ILD associated with CTD (ILD-CTD). Methods: A Retrospective descriptive study was conducted between 2008 and 2017. Data of 24 patients presenting ILD-CTD were collected. A review of HRCT was performed by a radiologist without knowledge of the CTD. Results: Predominant elementary lesion of ILD associated with dermatomyositis (9 cases) was ground glass opacity (n = 9) followed by consolidation (n = 6). Non Specific Interstitial Pneumonia (NSIP) was the most reported pattern (5 cases). Ground glass opacity was also the predominant elementary lesion for the 2 cases of scleroderma and in Sj&#246gren’s syndrome (4 cases/5). NSIP was the predominant radiological presentation in these two CTD. Lymphoid interstitial pneumonia revealed Sj&#246gren’s syndrome in one case. In rheumatoid arthritis (6 cases), the elementary HRCT lesions were irregular interlobular septal thickening (n = 4) and honeycombing (n = 4) consistent with Usual Interstitial Pneumonia (UIP) in 2 cases. Similarly UIP has been described for the 2 patients with lupus and mixed connective tissue disease. Conclusion: HRCT plays an important role in the management of ILD-CTD. Description of the HRCT elementary lesions and the radiological pattern of ILD can be helpful for CTD’s diagnosis.

Highlights

The high resolution computed tomography (HRCT) is an important part in the diagnostic approach of interstitial lung disease (ILD) associated with connective tissue diseases (CTD) by providing detailed information on the elementary lesion and the radiological pattern of ILD
The CVDs can cause a variety of ILDs, identical histologically to the idiopathic interstitial pneumonias, including non-specific interstitial pneumonia (NSIP), usual interstitial pneumonia (UIP), organizing pneumonia (OP), and lymphoid interstitial pneumonia (LIP) [3]
Diagnosis of CTD in our study was based on rheumatoid factor and anticyclic citrullinated peptide in rheumatoid arthritis (RA), anti-Jo-1 antibody in anti-synthetase syndrome (ASS), anti-topoisomerase antibodies in Scleroderma, anti-Ro (SSA), anti-La (SSB) in Sjogren’s syndrome, antinuclear antibodies in systemic lupus erythematosus (SLE) and U1 RNP antibodies in mixed connective tissue

Summary

Introduction

The high resolution computed tomography (HRCT) is an important part in the diagnostic approach of interstitial lung disease (ILD) associated with connective tissue diseases (CTD) by providing detailed information on the elementary lesion and the radiological pattern of ILD. Description of the HRCT elementary lesions and the radiological pattern of ILD can be helpful for CTD’s diagnosis. ILD represents an important part of the CTD morbidity with worsening prognosis and high mortality [2] Radiologist plays a key role in the multidisciplinary approach of ILD associated with CTD (ILD-CTD) His major tool is the high resolution computed tomography (HRCT), which plays an important role in all steps’ management. The aim of this study is to point out the role of HRCT in ILD-CTD’s diagnosis by identifying predominant elementary lesions and radiological pattern of ILD-CTD

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