Pleuroparenchymal fibroelastosis-like lesions on chest computed tomography in routine clinical practice

  • Hiromitsu SumikawaEmail author
  • Takeshi Johkoh
  • Tae Iwasawa
  • Katsuyuki Nakanishi
  • Noriyuki Tomiyama
Original Article



To evaluate the incidence and changes in the pleuroparenchymal fibroelastosis (PPFE)-like lesions on chest CT in routine clinical practice.

Materials and methods

This study included 1284 patients who underwent chest CT in 2011 at a hospital. The incidence of PPFE-like lesions and their correlation with age, body mass index, and concomitant pulmonary findings were assessed. Moreover, predictors of lesion progression were evaluated on follow-up. The ethical review board waived the requirement of informed consent for the retrospective review of patient records.


In total, 397 (30.9%) of the 1284 patients presented with PPFE-like lesions. The presence of PPFE-like lesions was correlated with older age (mean 72.2 vs. 69.9 years, p = 0.002); lower BMI (mean 21.0 vs. 23.2, p < 0.001); and interstitial pneumonia (64.8%, p < 0.001), emphysema (40.4%, p < 0.001), chronic airway disease (64.8%, p < 0.001), and old tuberculosis (56.5%, p < 0.001). Multivariate analysis of the follow-up CT findings revealed that interstitial pneumonia, nodular opacity, and lesion thickness affected progression (odds ratio: 3.81, 3.78 and 1.21), respectively.


Pleuroparenchymal fibroelastosis-like lesions were not rare and correlated with interstitial pneumonia, emphysema, chronic airway disease, and old tuberculosis. On follow-up, PPFE-like lesions in some patients with concomitant interstitial pneumonia exhibited progression.


Computed tomography Lung Pleuroparenchymal fibroelastosis Apical cap Interstitial pneumonia 



There is no funding to declare.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical standards

The ethical review board at our institution waived the requirement of patients’ approval or informed consent for the retrospective review of their records and images.


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Copyright information

© Japan Radiological Society 2019

Authors and Affiliations

  1. 1.Department of RadiologyOsaka International Cancer InstituteOsakaJapan
  2. 2.Department of Diagnostic RadiologySakai City Medical CenterSakaiJapan
  3. 3.Department of RadiologyKinki Central HospitalItamiJapan
  4. 4.Department of RadiologyKanagawa Cardiovascular and Respiratory CenterYokohamaJapan
  5. 5.Department of RadiologyOsaka Graduate School of MedicineOsakaJapan

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