Learning objectives
We aim to describe high-resolution computed tomography (HRCT) and display the corresponding histological features regarding interstitial lung changes related to smoking. Our goal is to elucidate the implications of different HRCT appearances on patient management.
Background
We researched literature on this topic and reviewed clinical cases from our hospital representative of different radiological and histopathological patterns.
Findings and procedure details
Cigarette smoking prompts the recruitment of inflammatory cells to small airways, even in the absence of clinical lung disease, that develops in a minority of cases.
Interstitial lung abnormalities (ground-glass opacities (GGO), cysts or centrilobular nodules) are present in 53,7% of smokers[1].
Main characteristics of smoking-related interstitial lung diseases (ILD) are summarized.[Fig 1]
1.Smoking-related ILD pattern - Inflammatory
Cigarette smoking is a risk factor for lung disease and an accepted primary cause of respiratory bronchiolitis interstitial lung disease (RB-ILD), desquamative interstitial pneumonia (DIP) and pulmonary...
Conclusion
Radiologists must consider multiple patterns of ILD when performing HRCT in smokers, which may coexist, knowing it can greatly impact therapeutic strategies.
Personal information and conflict of interest
F. L. C. Marques dos Santos:
Nothing to disclose
I. Marques:
Nothing to disclose
C. Senra:
Nothing to disclose
A. Sanches:
Nothing to disclose
C. Nogueira:
Nothing to disclose
S. Campainha:
Nothing to disclose
S. Neves:
Nothing to disclose
References
1-Otani,H., et al.(2016). Smoking-related interstitial fibrosis combined with pulmonary emphysema: computed tomography-pathologic correlative study using lobectomy specimens.Int J Chron Obstruct Pulmon Dis,Volume11,1521-1532
2-Iwasawa,T., et al.(2017). Smoking-related lung abnormalities on computed tomography images: comparison with pathological findings.Jpn J Radiol,36(3),165-180
3-Hansell,D., et al.(2008). Fleischner Society: Glossary of Terms for Thoracic Imaging.Radiology,246(3),697-722.
4-Sousa,C., et al.(2019). Diffuse smoking-related lung diseases: insights from a radiologic-pathologic correlation.Insights Imaging,10(1).
5-Raghu,G., et al.(2018). Diagnosis of Idiopathic Pulmonary Fibrosis. An Official ATS/ERS/JRS/ALAT Clinical Practice Guideline.Am J Respir Crit Care Med,198(5),e44-e68.
6-Kambouchner,M., et al.(2014). Prognostic...