Rofo 2007; 179(3): 268-275
DOI: 10.1055/s-2007-962842
Thorax

© Georg Thieme Verlag KG Stuttgart · New York

Interstitielle Lungenerkrankungen bei Rauchern

Smoking-Related Interstitial Lung DiseasesK. Marten1
  • 1Institut für Röntgendiagnostik, TU München, Klinikum rechts der Isar
Further Information

Publication History

eingereicht: 13.11.2006

angenommen: 12.12.2006

Publication Date:
26 February 2007 (online)

Zusammenfassung

Zentraler Gesichtspunkt der radiologischen Diagnostik interstitieller Lungenerkrankungen bei Rauchern ist die Tatsache, dass es sich hierbei um ein Spektrum von Erkrankungen mit häufiger Koexistenz bzw. Transformation der einzelnen Entitäten handelt. respiratorische bronchiolitisassoziierte interstitielle Lungenerkrankung (RBILD) und desquamative interstitielle Pneumonie (DIP) unterscheiden sich v. a. in der Lokalisation und der Ausprägung der akkumulierenden Alveolarmakrophagen sowie hinsichtlich des Grads der interstitiellen Veränderungen; ihre histopathologische Differenzierung (und daher auch die radiologische Differenzialdiagnose) ist im Einzelfall schwierig bzw. nicht möglich. Beide Entitäten kommen häufig als „Begleitbefund” bei Patienten mit pulmonale Langerhanszellhistiozytose (PLCH) vor. Einige Raucher können zusätzlich, möglicherweise als Folge einer DIP, eine Lungenfibrose entwickeln, die bildmorphologisch und histopathologisch einer NSIP entspricht - ein Zusammenhang, der im Rahmen zukünftiger Studien näher untersucht werden wird.

Abstract

The most important smoking-related interstitial lung diseases (ILD) are respiratory bronchiolitis, respiratory bronchiolitis-associated interstitial lung disease, desquamative interstitial pneumonia, and Langerhans’ cell histiocytosis. Although traditionally considered to be discrete entities, smoking-related ILDs often coexist, thus accounting for the sometimes complex patterns encountered on high-resolution computed tomography (HRCT). Further studies are needed to elucidate the causative role of smoking in the development of pulmonary fibrosis.

Literatur

  • 1 Britton J, Bates C, Channer K. Tobacco Advisory Group of the Royal College of Physicians. .Nicotine addiction in Britain: a report of the tobacco advisory group of the Royal College of Physicians. Sudbury; The Lavenham Press Ltd 2000 Vol 6
  • 2 Bartecchi C E, MacKenzie T D, Schrier R W. The human costs of tobacco use.  N Engl J Med. 1994;  330 907-980
  • 3 Murin S, Hilbert J, Reilly S J. Cigarette smoking and the lung.  Clin Rev Al Immunol. 1997;  15 307-336
  • 4 Reynolds H Y. Diagnostic and management strategies of diffuse interstitial lung disease.  Chest. 1998;  113 192-202
  • 5 Niewoehner D, Klinerman J, Rice D. Pathologic changes in the peripheral airways of young cigarette smokers.  N Engl J Med. 1974;  291 755-758
  • 6 Ryu J H, Colby T V, Hartman T E. et al . Smoking-related interstitial lung diseases: a concise review.  Eur Respir J. 2001;  17 122-132
  • 7 Myers J L, Veal C F, Shin M S. et al . Respiratory bronchiolitis causing interstitial lung disease: a clinicopathologic study of six cases.  Am Rev Respir Dis. 1987;  135 880-884
  • 8 Costabel U, Guzman J. Effect of smoking on bronchoalveolar lavage constituents.  Eur Respir J. 1992;  5 776-779
  • 9 Hunninghake G W, Crystal R G. Cigarette smoking and lung destruction: accumulation of neutrophils in the lungs of cigarette smokers.  Am Rev Respir Dis. 1993;  128 833-838
  • 10 Riise G C, Ahlstedt S, Larsson S. et al . Bronchial inflammation in chronic bronchitis assessed by measurement of cell products in bronchial lavage fluid.  Thorax. 1995;  50 360-365
  • 11 Marten K, Hansell D M. Imaging of macrophage-related lung diseases.  Eur Radiol. 2005;  15 727-741
  • 12 Yousem S A, Colby T V, Gaensler E A. Respiratory bronchiolitis-associated interstitial lung disease and its relationship to desquamative interstitial pneumonia.  Mayo Clin Proc. 1989;  64 1373-1380
  • 13 Moon J, du Bois R M, Colby T V. et al . Clinical significance of respiratory bronchiolitis on open lung biopsy and its relationship to smoking related interstitial lung disease.  Thorax. 1999;  54 1009-1014
  • 14 Gückel C, Hansell D M. Imaging the „dirty lung” - has high resolution computed tomography cleared the smoke?.  Clin Radiol. 1998;  53 717-722
  • 15 Carilli A D, Kotzen L M, Fischer M J. The chest roentgenogram in smoking females.  Am Rev Respir Dis. 1973;  107 133-136
  • 16 Dick J A, Morgan W KC, Muir D FC. et al . The significance of irregular opacities on the chest roentgenogram.  Chest. 1992;  102 251-260
  • 17 Remy-Jardin M, Remy J, Boulenguez C. et al . Morphologic effects of cigarette smoking on airways and pulmonary parenchyma in helathy adult volunteers: CT evaluation and correlation with pulmonary function tests.  Radiology. 1993;  93 107-115
  • 18 Hartman T E, Primack S L, Kang E Y. et al . Disease progression in usual interstitial pneumonia compared with desquamative interstitial pneumonia.  Chest. 1996;  110 378-382
  • 19 Heyneman L E, Ward S, Lynch D A. et al . Respiratory bronchiolitis, respiratory bronchiolitis-associated interstitial lung disease, and desquamative interstitial pneumonia: different entities or part of the spectrum of the same disease process?.  Am J Roentgenol. 1999;  173 1617-1622
  • 20 Park J, Tuder R, Brown K K. et al . Respiratory bronchiolitis-associated interstitial lung disease: CT-pathologic correlation.  Radiology. 1998;  209 179
  • 21 Remy-Jardin M, Edme J, Boulenguez C. et al . Longitudinal follow-up study of smoker’s lung with thin-section CT in correlation with pulmonary function tests.  Radiology. 2002;  222 261-270
  • 22 Liebow A A, Steer A, Billingsley J G. Desquamative interstitial pneumonia.  Am J Med. 1965;  39 369-404
  • 23 American Thoracic Society/European Respiratory Society . International multidisciplinary consensus classification of the idiopathic interstitial pneumonias.  Am J Respir Crit Care Med. 2002;  165 277-304
  • 24 Farr G H, Harley R A, Hennigan G R. Desquamative interstitial pneumonia: an electron microscopic study.  Am J Pathol. 1960;  60 347-370
  • 25 Katzenstein A A, Myers J L. Idiopathic pulmonary fibrosis: clinical relevance of pathologic classification.  Am J Respir Crit Care Med. 1998;  157 1301-1315
  • 26 Carrington C B, Gaensler E A, Coutu R E. et al . Natural history and treated course of usual and desquamative interstitial pneumonia.  N Engl J Med. 1978;  298 801-809
  • 27 Stillwell P C, Norris D G, O’Connell E J. et al . Desquamative interstitial pneumonitis in children.  Chest. 1980;  77 165-171
  • 28 Rawbone R G, Shaw M T, Jackson J G. et al . Complications of methotrexate-maintained remission in lymphoblastic leukemia.  BMJ. 1971;  4 24-31
  • 29 Lougheed M D, Roos J O, Waddell W R. et al . Desquamative interstitial pneumonitis and diffuse alveolar damage in textile workers: potential role of mycotoxins.  Chest. 1995;  108 1196-1200
  • 30 Goldstein J D, Godleski J J, Herman P G. Desquamative interstitial pneumonitis associated with monomyelocytic leukemia.  Chest. 1982;  81 321-325
  • 31 Bone R C, Wolfe J, Sobonya R E. et al . Desquamative interstitial pneumonia following chronic nitrofurantoin therapy.  Chest. 1982;  82 321-325
  • 32 Abraham J L, Hertzberg M A. Inorganic particulates associated with desquamative interstitial pneumonia.  Chest. 1981;  80 67-70
  • 33 Bokulic R E, Hilman B C. Interstitial lung disease in children.  Ped Clin N Am. 1994;  41 543-567
  • 34 Desai S R, Ryan S M, Colby T V. Smoking-related interstitial lung diseases: histopathological and imaging perspectives.  Clin Radiol. 2003;  58 259-268
  • 35 Akira M, Yamamoto S, Hara H. et al . Serial computed tomographic evaluation in desquamative interstitial pneumonia.  Thorax. 1997;  52 333-337
  • 36 Barberis M, Mazari S, Tironi A. et al . Recurrence of primary disease in a single lung transplant recipient.  Transplant Proc. 1992;  24 2660-2662
  • 37 Lipworth B, Woodcock A, Addis B. et al . Late relapse of desquamative interstitial pneumonia.  Am Rev Respir Dis. 1987;  136 1253-1255
  • 38 Verleden G M, Sels F, Van Raemdonck D. et al . Possible recurrence of desquamative interstitial pneumonitis in a single lung transplant recipient.  Eur Respir J. 1998;  11 971-974
  • 39 Patchevsky A S, Israel H L, Hoch W S. et al . Desquamative interstitial pneumonia: relationship to interstitial fibrosis.  Thorax. 1973;  28 680-693
  • 40 Feigen D S, Friedman P J. Chest radiography in desquamative interstitial pneumonitis: a review of 37 patients.  AJR Am J Roentgenol. 1980;  134 91-99
  • 41 Fraig M, Shreesha U, Savici D. et al . Respiratory bronchiolitis: a clinicopathologic study in current smokers, ex-smokers, and never-smokers.  Am J Surg Pathol. 2002;  26 647-653
  • 42 Colby T V. Bronchiolitis: pathologic considerations.  Am J Clin Pathol. 1998;  109 101-109
  • 43 Hartman T E, Primack S L, Swensen S J. et al . Desquamative interstitial pneumonia: thin-section CT-findings in 22 patients.  Radiology. 1993;  187 787-790
  • 44 Vedal S, Welsh E V, Miller R R. et al . Desquamative interstitial pneumonia: computed tomographic findings before and after treatment with corticosteroids.  Chest. 1988;  93 215-217
  • 45 Jokoh T, Muller N L, Cartier Y. et al . Idiopathic interstitial pneumonias: diagnostic accuracy of thin-section CT in 129 patients.  Radiology. 1999;  211 555-560
  • 46 Copley S J, Coren M, Nicholson A G. et al . Diagnostic accuracy of thin-section CT and chest radiography of pediatric interstitial lung disease.  AJR Am J Roentgenol. 2000;  174 549-554
  • 47 Chapman H A. Disorders of lung matrix remodeling.  J Clin Invest. 2004;  113 148-157
  • 48 Fraser R S, Muller N L, Colman N. et al .Inhalation of organic dusts. Fraser RS, Muller NL, Colman N, Pare PD Diagnosis of diseases of the chest Philadelphia; WB Saunders 1999: 2361-2385
  • 49 Cline M J. Histiocytes and histiocytosis.  Blood. 1994;  84 2840-2853
  • 50 Favara B E. Contemporary classification of histiocytic disorders.  Med Ped Oncol. 1997;  29 157-166
  • 51 Travis W D, Borok Z, Roum J H. et al . Pulmonary Langerhans cell granulomatosis (Histiocytosis X): a clinicopathologic study of 48 cases.  Am J Surg Pathol. 1993;  17 971-986
  • 52 Soler P, Kambouchner M, Valeyre D. et al . Pulmonary Langerhans’ cell histiocytosis (Histiocytosis X).  Am Rev Med. 1992;  43 105-115
  • 53 Vassallo R, Ryu J H, Colby T V. et al . Pulmonary Langerhans’-cell histiocytosis.  N Engl J Med. 2002;  342 1969-1978
  • 54 Tazi A, Soler P, Hance A J. Adult pulmonary Langerhans’ cell histiocytosis.  Thorax. 2000;  55 405-416
  • 55 Smets A, Mortele K, Praeter de G. et al . Pulmonary and mediastinal lesions in children with Langerhans cell histiocytosis.  Ped Radiol. 1997;  27 873-876
  • 56 Yousem S A, Colby T V, Weiss L M. Pulmonary Langerhans’ cell histiocytosis: molecular analysis of clonality.  Am J Surg Pathol. 2001;  25 630-636
  • 57 Brown R E. Pulmonary Langerhans’ cell histiocytosis.  New Engl J Med. 2000;  343 1654-1656
  • 58 Colby T V, Carrington C B. Interstitial lung disease. Thurlbeck WM, Churg AM Pathology of the lung New York; Thieme Medical Publishers 1995: 589-737
  • 59 Colby T V, Lombard C. Histiocytosis X in the lung.  Hum Pathol. 1983;  14 847-856
  • 60 Kambouchner M, Basset F, Soler P. Tridimensional features of pulmonary Langerhans cell granulomatosis (PLCG) lesions.  Mod Pathol. 1996;  9 157-162
  • 61 Friedman P J, Liebow A A, Sokoloff J. Eosinophilic granuloma of lung: clinical aspects of primary pulmonary histiocytosis in the adult.  Medicine. 1981;  60 385-396
  • 62 Mogulkuc N, Veral A, Bishop P W. et al . Pulmonary Langerhans’ cell histiocytosis: radiologic resolution following smoking cessation.  Chest. 1999;  115 1452-1455
  • 63 Von Essen S, West W, Sitorius M. et al . Complete resolution of roentgenographic changes in a patient with pulmonary histiocytosis X.  Chest. 1990;  98 765-767
  • 64 Lacronique J, Roth C, Battesti J P. et al . Chest radiological features of pulmonary histiocytosis X: a report based on 50 adult cases.  Thorax. 1982;  37 104-109
  • 65 Fichtenbaum C J, Kleinman G M, Haddad R G. Eosinophilic granuloma of the lung presenting as a solitary pulmonary nodule.  Thorax. 1990;  45 905-906
  • 66 Pomeranz S J, Proto A V. Histiocytosis X: unusual-confusing features of eosinophilic granuloma.  Chest. 1986;  89 88-92
  • 67 Tazi A, Montcelly L, Bergeron A. et al . Relapsing nodular lesions in the course of adult pulmonary Langerhans cell histiocytosis.  Am J Respir Crit Care Med. 1998;  157 216-223
  • 68 Etienne B, Bertocchi M, Gamondes J P. et al . Relapsing pulmonary Langerhans cell histiocytosis after lung transplantation.  Am J Respir Crit Care Med. 1998;  157 288-291
  • 69 Brauner M W, Grenier P, Tijani K. et al . Pulmonary Langerhans cell histiocytosis: evolution of lesions on CT scans.  Radiology. 1997;  204 497-502
  • 70 Moore A DA, Godwin J D, Muller N L. et al . Pulmonary histiocytosis X: comparison of radiographic and CT findings.  Radiology. 1989;  172 249-254
  • 71 Brauner M W, Grenier P, Mouelhi M M. et al . Pulmonary histiocytosis X: evaluation with high-resolution CT.  Radiology. 1989;  172 255-258
  • 72 Soler P, Bergeron A, Kambouchner M. et al . Is high-resolution computed tomography a reliable tool to predict the histopathological activity of pulmonary Langerhans cell histiocytosis?.  Am J Respir Crit Care Med. 2000;  162 264-270
  • 73 Kirchner J, Stein A, Viel K. et al . Pulmonary lymphangioleiomyomatosis: high-resolution CT findings.  Eur Radiol. 1999;  9 49-54
  • 74 Keyzer C, Bankier A A, Remmelinck M. et al . Pulmonary lymphangiomyomatosis mimicking Langerhans cell histiocytosis.  J Thorac Imaging. 2001;  16 185-187
  • 75 Anderson L G, Talal N. The spectrum of benign to malignant lymphoproliferation in Sjogren’s syndrome.  Clin Exp Immunol. 1971;  9 100-221
  • 76 Koss M N, Hochholzer L, Langloss J M. et al . Lymphoid interstitial pneumonia: clinicopathological and immunopathological findings in 18 cases.  Pathology. 1986;  19 178-185
  • 77 Vassallo R, Jensen E A, Colby T V. et al . The overlap between respiratory bronchiolitis and desquamative interstitial pneumonia in pulmonary Langerhans cell histiocytosis.  Chest. 2003;  124 1199-1205
  • 78 Cardoso W V, Sekhon H S, Hyde D M. et al . Collagen and elastin in human pulmonary emphysema.  Am Rev Respir Dis. 1993;  147 975-981
  • 79 Lang M R, Fiaux G W, Gillooly M. et al . Collagen content of alveolar wall tissue in emphysematous and non-emphysematous lungs.  Thorax. 1994;  49 319-326
  • 80 Baumgartner K B, Samet J M, Stidley C A. et al . Cigarette smoking: a risk factor for idiopathic pulmonary fibrosis.  Am J Respir Crit Care Med. 1997;  155 242-248
  • 81 Craig P J, Wells A U, Doffman S. et al . Desquamative interstitial pneumonia, respiratory bronchiolitis and their relationship to smoking.  Histopathology. 2004;  45 275-282
  • 82 Marten K, Milne D, Nicholson A G. et al . Zigarettenrauchbedingte nicht-spezifische interstitielle Pneumonie (sr-NSIP): Clustering mit Emphysem und CT-basierte Differenzierung von idiopathischer NSIP.  Fortschr Röntgenstr. 2006;  178 S139

Dr. Katharina Marten

Institut für Röntgendiagnostik, TU München, Klinikum rechts der Isar

Ismaningerstr. 22

81675 München

Phone: ++49/89/41 40 26 21

Fax: ++4 9/89/41 40 48 34

Email: Katharina.Marten@roe.med.tu-muenchen.de

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