Premium
Histological analysis of vasculopathy associated with pulmonary hypertension in combined pulmonary fibrosis and emphysema: comparison with idiopathic pulmonary fibrosis or emphysema alone
Author(s) -
Awano Nobuyasu,
Inomata Minoru,
Ikushima Soichiro,
Yamada Daisuke,
Hotta Masatoshi,
Tsukuda Shunji,
Kumasaka Toshio,
Takemura Tamiko,
Eishi Yoshinobu
Publication year - 2017
Publication title -
histopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.626
H-Index - 124
eISSN - 1365-2559
pISSN - 0309-0167
DOI - 10.1111/his.13153
Subject(s) - medicine , pulmonary emphysema , pulmonary fibrosis , pulmonary hypertension , pathology , fibrosis , idiopathic pulmonary fibrosis , pulmonary pathology , cardiology , lung
Aims To evaluate pulmonary vasculopathy in an autopsy series of patients with combined pulmonary fibrosis and emphysema ( CPFE ), and compare these findings with those of patients with idiopathic pulmonary fibrosis ( IPF ) alone and emphysema alone. Methods and results We retrospectively analysed the clinical, radiological and pathological features of 26 patients with CPFE , 11 with IPF , and 23 with emphysema. We evaluated pulmonary vascular, venous–venular and arteriolar tissue changes in the fibrotic, emphysematous and relatively unaffected (preserved) areas by using the Heath–Edwards scoring system. We found moderate‐to‐severe vasculopathy in the CPFE group, but no significant differences in the fibrotic and emphysematous areas among the three groups. However, in the preserved area, the grading was significantly different among the three groups ( P < 0.001), and vasculopathy in the CPFE group was the most severe. Although venous–venular and arteriolar changes in almost all fibrotic and emphysematous areas in the three groups showed no significant differences, there were significant differences in venous–venular ( P = 0.004) and arteriolar ( P < 0.001) changes in the preserved area among the three groups, which were most prevalent in the CPFE group. In the CPFE group, venous–venular changes and vasculopathy by Heath–Edwards grading were highest in the fibrotic area and lowest in the preserved area. Conclusions These results imply that pulmonary vasculopathy in patients with CPFE could occur in the whole lung tissue. This may explain the tendency for it to lead to the development of pulmonary hypertension in CPFE cases.