Der Radiologe

, Volume 53, Issue 9, pp 817–830 | Cite as

Interstitielle Lungenerkrankungen (ILD) bei Rauchern

Spektrum in der hochauflösenden Computertomographie (HRCT)
CME Zertifizierte Fortbildung

Zusammenfassung

Zigarettenrauchen ist ein bekannter Risikofaktor für die Entwicklung mehrerer ILD (z. B. respiratorische Bronchiolitis, respiratorische bronchiolitisassoziierte ILD, desquamative interstitielle Pneumonie, pulmonale Langerhans-Zell-Histiozytose). Diese zigarettenrauchbedingten ILD sind überlappende klinisch-pathologische Entitäten, die häufig koexistieren. Im klinischen Alltag ist eine klare diagnostische Abgrenzung dieser Erkrankungen nicht immer möglich, es handelt sich vielmehr um Teile desselben Krankheitsspektrums, welche unterschiedliche Schweregrade der Lungenparenchymschädigung nach Zigarettenrauchexposition repräsentieren. Der Zusammenhang zwischen Rauchen und der Entwicklung einer Lungenfibrose ist komplex und Gegenstand intensiver Forschung. Er umfasst nicht nur Patienten mit mutmaßlich zigarettenrauchassoziierter nichtspezifischer interstitieller Pneumonie, sondern auch die CPFE („combined pulmonary fibrosis and emphysema“) als neue Entität mit klar definierten klinisch-radiologischen Charakteristika.

Schlüsselwörter

Lungenfibrose Rauchen Bronchiolitis Langerhans-Zell-Histiozytose Interstitielle Lungenerkrankungen 

Interstitial lung diseases (ILD) in smokers

Spectrum in high resolution computed tomography (HRCT)

Abstract

Smoking is a known risk factor for the development of various interstitial lung diseases, e.g. respiratory bronchiolitis, respiratory bronchiolitis-associated interstitial lung disease, desquamative interstitial pneumonia, and pulmonary Langerhans cell histiocytosis. These disorders frequently present with overlapping clinical pathological features and in addition may coexist within the same patient. In the clinical routine the differential diagnosis may be challenging or even impossible; therefore, smoking-related lung diseases are considered as part of the same disease spectrum representing different degrees of lung parenchymal damage secondary to cigarette smoke exposure. The role of cigarette smoking in the development of pulmonary fibrosis is complex and subject to intense investigation. It encompasses a subset of patients with nonspecific interstitial pneumonia where cigarette smoking may have played a causative role as well as patients with combined pulmonary fibrosis and emphysema (CPFE) as a novel entity with clearly defined clinical radiological features.

Keywords

Pulmonary fibrosis Smoking Bronchiolitis Histiocytosis, Langerhans cell Interstitial lung diseases 

Notes

Einhaltung ethischer Richtlinien

Interessenkonflikt. K. Marten-Engelke gibt an, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  1. 1.Praxis für moderne Schnittbild-DiagnostikGöttingenDeutschland

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