Advertisement

Rheumatology International

, Volume 26, Issue 2, pp 121–125 | Cite as

Nonspecific interstitial pneumonia pattern as pulmonary involvement of rheumatoid arthritis

  • T. Yoshinouchi
  • Y. Ohtsuki
  • J. FujitaEmail author
  • I. Yamadori
  • S. Bandoh
  • T. Ishida
  • R. Ueda
Original Article

Abstract

The pathologic patterns of lung involvement were evaluated in 16 patients with rheumatoid arthritis (RA). They consisted of six females and ten males, with a median age of 67.5 years and diagnosed according to the American Rheumatism Association revised criteria. High-resolution computed tomography (HRCT) of the lungs was performed in all patients, and honeycomb formation was apparent in seven. Histopathologically, seven patients were diagnosed with usual interstitial pneumonia (UIP) pattern, seven with nonspecific interstitial pneumonia/fibrosis (NSIP) pattern, and two with UIP/NSIP hybrid pattern. There were no apparent honeycomb formations on HRCT in patients diagnosed with NSIP pattern. In conclusion, the present study demonstrates that NSIP pattern is also a significant histologic classification of interstitial pneumonia associated with RA.

Keywords

Honeycomb High-resolution computed tomography Nonspecific interstitial pneumonia/fibrosis Rheumatoid arthritis Usual interstitial pneumonia 

References

  1. 1.
    Ellman P, Ball RE (1948) “Rheumatoid disease” with joint and pulmonary manifestations. Br Med J 6:816–820Google Scholar
  2. 2.
    Yardumian K, Kleinerman J (1949) Pathogenesis of so-called diffuse vascular or collagen disease. Arch Intern Med 83:1–26Google Scholar
  3. 3.
    Katz HL, Auerbach O (1951) Diffuse interstitial fibrosis of the lungs; report of a case with unusual features Dis Chest 20:366–377PubMedGoogle Scholar
  4. 4.
    Bevans M, Nadell J, Demartini F, Ragan C (1954) The systemic lesions of malignant rheumatoid arthritis. Am J Med 16:197–211PubMedGoogle Scholar
  5. 5.
    Christie GS (1954) Pulmonary lesions in rheumatoid arthritis. Australas Ann Med 3:49–58PubMedGoogle Scholar
  6. 6.
    Rubin EH (1955) Pulmonary lesions in rheumatoid disease with remarks on diffuse interstitial pulmonary fibrosis. Am J Med 19:569–582CrossRefPubMedGoogle Scholar
  7. 7.
    Price TM, Skelton MO (1956) Rheumatoid arthritis with lung lesions. Thorax 11:234–240PubMedGoogle Scholar
  8. 8.
    Ellman P (1956) Pulmonary manifestations in the systemic collagen diseases. Postgrad Med J 32:370–387PubMedGoogle Scholar
  9. 9.
    Skogrand A (1956) Visceral lesions in rheumatoid arthritis. Acta Rheumatol Scand 2:17–30PubMedGoogle Scholar
  10. 10.
    Edge JR, Rickards AG (1957) Rheumatoid arthritis with lung lesions. Thorax 12:352–357PubMedGoogle Scholar
  11. 11.
    Dixon ASJ, Ball J (1957) Honeycomb lung and chronic rheumatoid arthritis. A case report. Ann Rheum Dis 16:241–245PubMedGoogle Scholar
  12. 12.
    Cruickshank A (1959) Interstitial pneumonia and its consequences in rheumatoid disease. Br J Dis Chest 53:226–236PubMedGoogle Scholar
  13. 13.
    Ognibene AJ (1960) Systemic “rheumatoid disease” with interstitial pulmonary fibrosis. A report of two cases. Arch Intern Med 105:762–769PubMedGoogle Scholar
  14. 14.
    Cudkowicz L, Madoff IM, Abelmann WH (1961) Rheumatoid lung disease. A case report which includes respiratory function studies and a lung biopsy. Br J Dis Chest 55:35–40PubMedGoogle Scholar
  15. 15.
    Locke GB (1963) Rheumatoid lung. Clin Radiol 14:43–53PubMedGoogle Scholar
  16. 16.
    Brannan HM, Good CA, Divertie MB, Baggenstoss AH (1964) Pulmonary disease associated with rheumatoid arthritis. JAMA 189:914–918PubMedGoogle Scholar
  17. 17.
    Rubin EH, Gordon M, Thelmo WL (1967) Nodular pleuropulmonary rheumatoid disease. Report of two cases and review of the literature. Am J Med 42:567–581CrossRefPubMedGoogle Scholar
  18. 18.
    Walker WC, Wright V (1968) Pulmonary lesions and rheumatoid arthritis. Medicine 47:501–520PubMedGoogle Scholar
  19. 19.
    Scadding JG (1969) The lungs in rheumatoid arthritis. Proc Roy Soc Med 62:227–238PubMedGoogle Scholar
  20. 20.
    Geddes DM, Webley M, Brewerton DA, Turton CW, Turner-Warwick M, Murphy AH, Ward AM (1977) α1-antitrypsin phenotypes in fibrosing alveolitis and rheumatoid arthritis. Lancet 2:1049–1051CrossRefPubMedGoogle Scholar
  21. 21.
    Yousem SA, Colby TV, Carrington CB (1985) Lung biopsy in rheumatoid arthritis. Am Rev Respir Dis 131:770–777PubMedGoogle Scholar
  22. 22.
    Roschmann RA, Rothenberg RJ (1987) Pulmonary fibrosis in rheumatoid arthritis: a review of clinical features and therapy. Sem Arthritis Rheum 16:174–185CrossRefGoogle Scholar
  23. 23.
    Hakala M,Paakko P, Huhti E, Tarkka M, Sutinen S (1990) Open lung biopsy of patients with rheumatoid arthritis. Clin Rheumatol 9:452–460PubMedGoogle Scholar
  24. 24.
    Katzenstein A, Fiorelli RF (1994) Nonspecific interstitial pneumonia/fibrosis. Histologic features and clinical significance. Am J Surg Pathol 18:136–147PubMedGoogle Scholar
  25. 25.
    Arnett FC, Edworthy SM, Bloch DA, McShane DJ, Fries JF, Cooper NS, Healey LA, Kaplan SR, Liang MH, Luthra HS et al (1988) The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum 31:315–324PubMedGoogle Scholar
  26. 26.
    American Thoracic Society (2000) Idiopathic pulmonary fibrosis: diagnosis and treatment. International consensus statement. American Thoracic Society (ATS) and the European Respiratory Society (ERS). Am J Respir Crit Care Med 161:646-664PubMedGoogle Scholar
  27. 27.
    Katzenstein AL, Myers JL (1998) Idiopathic pulmonary fibrosis. Clinical relevance of pathologic classification. Am J Respir Crit Care Med 157:1301-1315PubMedGoogle Scholar
  28. 28.
    Izumi T, Kitaichi M, Nishimura K, Nagai S (1992) Bronchiolitis obliterans organizing pneumonia. Clinical features and differential diagnosis. Chest 102:715-719PubMedGoogle Scholar
  29. 29.
    Bjoraker JA, Ryu JH, Edwin MK, Myers JL, Tazalaar HD, Schroeder DR, Offord KP (1998) Prognostic significance of histopathologic subsets in idiopathic pulmonary fibrosis. Am J Respir Crit Care Med 157:199–203PubMedGoogle Scholar
  30. 30.
    Daniil ZD, Gilchrist FC, Nicholson AG, Hansell DM, Harris J, Colby TV, du Bois RM (1999) A histologic pattern of nonspecific interstitial pneumonia is associated with a better prognosis than usual interstitial pneumonia in patients with cryptogenic fibrosing alveolitis. Am J Respir Crit Care Med 160:899–905PubMedGoogle Scholar
  31. 31.
    Remy-Jardin M, Remy J, Cortet B, Mauri F, Delcambre B (1994) Lung changes in rheumatoid arthritis: CT findings. Radiology 193:375–382PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  • T. Yoshinouchi
    • 1
  • Y. Ohtsuki
    • 2
  • J. Fujita
    • 3
    Email author
  • I. Yamadori
    • 4
  • S. Bandoh
    • 3
  • T. Ishida
    • 3
  • R. Ueda
    • 5
  1. 1.Toyokawa City HospitalAichiJapan
  2. 2.Department of Tumor PathologyKochi UniversityKochiJapan
  3. 3.First Department of Internal Medicine, Faculty of MedicineKagawa UniversityKagawa 761-0793Japan
  4. 4.Clinical Laboratory DepartmentNational Okayama Medical CenterOkayamaJapan
  5. 5. Department of Internal Medicine and Molecular ScienceNagoya City University Graduate School of Medical ScienceAichiJapan

Personalised recommendations