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Effect of the 2020 hypersensitivity pneumonitis guideline on the pathologic diagnosis of interstitial pneumonia.
Ozasa, Mutsumi; Bychkov, Andrey; Zaizen, Yoshiaki; Tabata, Kazuhiro; Uegami, Wataru; Yamano, Yasuhiko; Kataoka, Kensuke; Johkoh, Takeshi; Mukae, Hiroshi; Kondoh, Yasuhiro; Fukuoka, Junya.
Afiliación
  • Ozasa M; Department of Pathology Informatics, Nagasaki University Graduate School of Biomedical Sciences, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan.
  • Bychkov A; Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
  • Zaizen Y; Department of Pathology Informatics, Nagasaki University Graduate School of Biomedical Sciences, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan.
  • Tabata K; Department of Pathology, Kameda Medical Center, Kamogawa, Chiba, Japan.
  • Uegami W; Department of Pathology Informatics, Nagasaki University Graduate School of Biomedical Sciences, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan.
  • Yamano Y; Department of Pathology Informatics, Nagasaki University Graduate School of Biomedical Sciences, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan.
  • Kataoka K; Department of Pathology Informatics, Nagasaki University Graduate School of Biomedical Sciences, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan.
  • Johkoh T; Department of Pathology, Kameda Medical Center, Kamogawa, Chiba, Japan.
  • Mukae H; Department of Respiratory Medicine and Allergy, Tosei General Hospital, Seto, Aichi, Japan.
  • Kondoh Y; Department of Respiratory Medicine and Allergy, Tosei General Hospital, Seto, Aichi, Japan.
  • Fukuoka J; Department of Radiology, Kansai Rosai Hospital, Amagasaki, Hyogo, Japan.
Sci Rep ; 13(1): 9318, 2023 06 08.
Article en En | MEDLINE | ID: mdl-37291357
ABSTRACT
It was reported that the 2020 guideline for hypersensitivity pneumonitis (HP) might result in the overdiagnosis of fibrotic HP (fHP). fHP and other types of interstitial pneumonias have several overlapping characteristics, and a high diagnostic concordance rate of fHP is rarely obtained. Therefore, we investigated the impact of the 2020 HP guideline on the pathological diagnosis of cases previously diagnosed as interstitial pneumonia. We identified 289 fibrotic interstitial pneumonia cases from 2014 to 2019 and classified them into four categories according to the 2020 HP guideline typical, probable, and indeterminate for fHP and alternative diagnosis. The original pathological diagnosis of 217 cases were compared to their classification as either typical, probable, or indeterminate for fHP according to the 2020 guideline. The clinical data, including serum data and pulmonary function tests, were compared among the groups. Diagnoses changed from non-fHP to fHP for 54 (25%) of the 217 cases, of which, 8 were typical fHP and 46 were probable fHP. The ratio of typical and probable fHP cases to the total number of VATS cases was significantly lower when using transbronchial lung cryobiopsy (p < 0.001). The clinical data of these cases bore a more remarkable resemblance to those diagnosed as indeterminate for fHP than to those diagnosed as typical or probable. The pathological criteria in the new HP guidelines increase the diagnosis of fHP. However, it is unclear whether this increase leads to overdiagnosis, and requires further investigation. Transbronchial lung cryobiopsy may not be helpful when using the new criteria to impart findings for fHP diagnosis.
Asunto(s)

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Enfermedades Pulmonares Intersticiales / Alveolitis Alérgica Extrínseca Tipo de estudio: Diagnostic_studies / Guideline / Prognostic_studies Límite: Humans Idioma: En Revista: Sci Rep Año: 2023 Tipo del documento: Article País de afiliación: Japón

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Enfermedades Pulmonares Intersticiales / Alveolitis Alérgica Extrínseca Tipo de estudio: Diagnostic_studies / Guideline / Prognostic_studies Límite: Humans Idioma: En Revista: Sci Rep Año: 2023 Tipo del documento: Article País de afiliación: Japón