Smoking Related Interstitial Lung Disease - High Resolution Computed Tomography (HRCT) findings in 40 smokers

Abstract

The aim of the study is to delineate the relation between cigarette smoking and the development of interstitial lung disease with declaration of the different types of the interstitial lung associated with smoking. HRCT was done on 40 smokers. All patients had thorough clinical assessment. Blood gases were estimated in all patients. Pulmonary function tests were done to all subjects, BAL was done in 27 patients, and trans-bronchial biopsy was done in 14 patients. None of the patients agreed to do any surgical biopsies. In 25 patients (n = 25, 62.5%) the HRCT findings suggested RB-ILD. Five patients (n = 5, 12.5%), were diagnosed as early DIP. Three patients (n = 3, 7.5%) showed advanced DIP. In six patients (n = 6, 15%) the findings suggests UIP and one patient (30 year-old) had findings suggesting PLCH. In the appropriate clinical context high-resolution CT plays an integral role in the evaluation of SR-ILD, the presence of typical changes at high-resolution CT renders the diagnosis almost certain and may obviate further testing. Lung biopsy may be needed when the findings at high-resolution CT are relatively nonspecific or when a confident definitive diagnosis is needed.

Keywords

• CPFE combined pulmonary fibrosis with emphysema
• DIP desquamative interstitial pneumonitis
• IIP idiopathic interstitial pneumonia
• IPF idiopathic pulmonary fibrosis
• PFT pulmonary function test
• PLCH pulmonary Langerhans cell histiocytosis
• RB-ILD respiratory bronchiolitis ILD
• SR-ILD smoking-related ILD
• UIP usual interstitial pneumonia