| Institution: | 1. Nagasaki Educational and Diagnostic Center of Pathology (NEDCP), Nagasaki University, Nagasaki, Japan;2. Department of Respiratory Medicine & Allergy, Tosei General Hospital, Aichi, Japan;3. Respiratory Institution for Diseases of the Chest, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan;4. Department of Pathology, School of Medicine, Kurume University, Fukuoka, Japan;5. Division of Respiratory Medicine, Saiseikai Kumamoto Hospital, Kumamoto, Japan;6. Department of Respiratory Medicine, Okinawa Chubu Hospital, Okinawa, Japan;7. Nagasaki University Hospital, Clinical Research Center, Nagasaki, Japan;1. Department of Respiratory Medicine and Allergy, Tosei General Hospital, Seto, Aichi;2. Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, Nagoya, Aichi;3. Department of Radiology, Kinki Central Hospital of Mutual Aid Association of Public School Teachers, Itami, Hyogo;4. Department of Radiology, Kurume University School of Medicine, Kurume, Fukuoka;5. Department of Laboratory of Pathology, Nagasaki University Hospital, Nagasaki, Nagasaki;6. Department of Diagnostic Pathology, Kobe University Hospital, Kobe, Hyogo;7. Department of Respiratory Medicine and Allergology, Kinki University Faculty of Medicine, Osaka-sayama, Osaka, Japan;1. Wuxi School of Medicine, Jiangnan University, Wuxi, China;2. Department of Clinical Medicine and Center for Experimental Medicine, Jiangsu Health Vocational College, Nanjing, China;3. Institute of Biomedical Research, Liaocheng University, Liaocheng, China;1. Department of Pathology and Pathophysiology, School of Biology and Basic Medical Sciences, Soochow University, Soochow, China;2. Institute of Biomedical Research, Liaocheng University, Liaocheng, China;3. The Laboratory Center for Basic Medical Sciences, Nanjing Medical University, Nanjing, China;4. Department of Pathophysiology, Wuxi School of Medicine, Jiangnan University, Wuxi, China;5. Department of Clinical Medicine, Jiangsu Health Vocational College, Nanjing, China;6. Department of Pathophysiology, School of Basic Medical Sciences, Nanjing Medical University, Nanjing, China |
| Abstract: | BackgroundPulmonary interstitial emphysema is a rare, abnormal condition in which air pressure from the alveolar airspace tears the adjacent interstitial tissues of the lung and causes the formation of cystic spaces. Pulmonary interstitial emphysema is a known indication for mechanical ventilation in premature infants with neonatal respiratory distress syndrome, and it can be observed in various types of interstitial lung disease. Nevertheless, its pathogenesis and clinical impact remain unknown.MethodsWe reviewed data from 433 cases of interstitial lung disease from an external consultation archive. Multidisciplinary diagnosis along with clinical and follow-up data, including events of air leaks such as pneumothorax and mediastinal emphysema, were obtained and compared to those of 150 control cases of interstitial lung disease without pulmonary interstitial emphysema.ResultsWe found 22 (5.1%) cases of interstitial lung disease with pulmonary interstitial emphysema. The diagnoses included idiopathic pulmonary fibrosis (5/22 22.7%]), pleuroparenchymal fibroelastosis (4/22 18.2%]), chronic hypersensitivity pneumonia (4/22 18.2%]), and others (9/22 40.9%]). Cases involving pulmonary interstitial emphysema demonstrated a significantly higher frequency of air leaks than did those without pulmonary interstitial emphysema (12/22 54.5%] versus 23/150 15.3%]; P < 0.001; odds ratio, 6.63) and were associated with worse prognosis (P = 0.009 log-rank]) and a lower median percent forced vital capacity (73.2% versus 84.0%; P < 0.001).ConclusionsWe found that pulmonary interstitial emphysema is an independent factor for poor prognosis, which also shows a trend to cause air leaks, including pneumothorax and mediastinal emphysema. |
