Susam Seher, Ucsular Fatma Demirci, Yalniz Enver, Cinkooglu Akin, Polat Gulru, Komurcuoglu Berna Eren, Anar Ceyda, Karadeniz Gulistan, Cirak Ali Kadri, Tellioglu Emel, Guldaval Filiz, Gayaf Mine, Aksel Nimet, Batum Ozgur, Alizoroglu Dursun, Bilaceroglu Semra
Department of Radiology, Chest Disease and Thoracic Surgery Training and Research Hospital, Health Sciences University, Izmir, Turkey.
Department of Chest Disease, Chest Disease and Thoracic Surgery Training and Research Hospital, Health Sciences University, Izmir, Turkey.
Ann Thorac Med. 2021 Jan-Mar;16(1):118-125. doi: 10.4103/atm.ATM_187_20. Epub 2021 Jan 14.
This study aims to investigate whether there is a significant difference between typical and atypical parenchymal patterns in the development of fibrosis, which is the most crucial factor affecting morbidity in pulmonary sarcoidosis.
In our hospital, 145 cases with Siltzbach Types 2 and 3 sarcoidoses diagnosed by clinical, radiological, and histopathologic were retrospectively investigated. Perilymphatic nodules, accompanying mosaic attenuation, and interlobular septal thickening and central peribronchovascular bunch-like thickening on high-resolution computed tomography were assessed as typical. Solid nodules, galaxy finding, consolidation, ground-glass opacity, isolated mosaic attenuation, and interlobular septal thickening, and pleural fluid were accepted as atypical findings. Findings indicating fibrosis were fine and rough reticular opacity, traction bronchiectasis, volume loss, and cystic changes. For the analysis of variables, SPSS 25.0 program was used.
Ten (16%) of the 61 cases with typical findings and 16 (19%) of the 84 with atypical findings developed fibrosis ( = 0.827). The mean age of cases with fibrosis was higher. With the cut-off of 50 years, sensitivity was 61.5%, and specificity was 68.9%. The highest fibrosis rate was in cases with ground glass pattern ( = 7/17), whereas higher reversibility rates were in those with miliary pattern ( = 9/12) and galaxy sign ( = 5/6).
The incidence of fibrosis is higher in the atypical group with no significant difference. The incidence of fibrosis differs in each atypical pattern, being highest in ground-glass opacity and lowest in the miliary pattern.
本研究旨在调查在纤维化发展过程中，典型和非典型实质模式之间是否存在显著差异，纤维化是影响肺结节病发病率的最关键因素。
回顾性调查我院145例经临床、放射学和组织病理学诊断为Siltzbach 2型和3型结节病的患者。高分辨率计算机断层扫描上的淋巴管周围结节、伴随的马赛克衰减、小叶间隔增厚以及中央支气管血管束样增厚被评估为典型表现。实性结节、星系征、实变、磨玻璃影、孤立性马赛克衰减、小叶间隔增厚以及胸腔积液被视为非典型表现。提示纤维化的表现为细网状和粗网状混浊、牵拉性支气管扩张、肺容积缩小和囊性改变。使用SPSS 25.0程序进行变量分析。
61例典型表现患者中有10例（16%）发生纤维化，84例非典型表现患者中有16例（19%）发生纤维化（P = 0.827）。发生纤维化的患者平均年龄较高。以50岁为界值，敏感性为61.5%，特异性为68.9%。纤维化发生率最高的是磨玻璃样表现的患者（7/17），而粟粒样表现（9/12）和星系征（5/6）的患者可逆率较高。
非典型组纤维化发生率较高，但无显著差异。每种非典型模式的纤维化发生率不同，磨玻璃影中最高，粟粒样表现中最低。
