Radiology, Vol 186, 643-651, Copyright © 1993 by Radiological Society of North America

ARTICLES

Lung parenchymal changes secondary to cigarette smoking: pathologic-CT correlations

M Remy-Jardin, J Remy, B Gosselin, V Becette and JL Edme
Department of Radiology, Hopital Calmette, CHRU de Lille, France.

To determine the histopathologic basis for computed tomographic (CT) interpretation of smokers' lung and the accuracy of CT in the detection of alterations related to cigarette smoking, parenchymal lung lesions were studied from 41 heavy smokers who underwent thoracotomy for removal of a solitary pulmonary nodule. CT scanning of the resected lungs, corresponding exactly to the sections seen on preoperative CT scans, resulted in the following pathologic-CT correlations. Areas of ground-glass attenuation seen on preoperative CT scans (n = 11 [27%]) were related to three main histologic features: (a) accumulation of pigmented macrophages and mucus in the alveolar spaces, associated with mild interstitial inflammation and/or fibrosis (n = 7); (b) thickening of the alveolar walls with inflammatory cells with normal alveolar spaces (n = 3); and (c) presence of organizing alveolitis (n = 1). Parenchymal micronodules depicted presurgically (n = 4 [10%]) corresponded to bronchiolectases with peribronchiolar fibrosis (n = 4) associated with obliterative bronchiolitis in one patient. When emphysema was detected presurgically (n = 21 [51%]), it was always present at pathologic study to a higher extent than initially suspected.

This article has been cited by other articles:

				W. D. Travis, G. Hunninghake, T. E. King Jr., D. A. Lynch, T. V. Colby, J. R. Galvin, K. K. Brown, M. P. Chung, J.-F. Cordier, R. M. du Bois, et al. Idiopathic Nonspecific Interstitial Pneumonia: Report of an American Thoracic Society Project Am. J. Respir. Crit. Care Med., June 15, 2008; 177(12): 1338 - 1347. [Abstract] [Full Text] [PDF]

				A. U Wells, A. G Nicholson, and D. M Hansell Challenges in pulmonary fibrosis {middle dot} 4: Smoking-induced diffuse interstitial lung diseases Thorax, October 1, 2007; 62(10): 904 - 910. [Abstract] [Full Text] [PDF]

				M. Nakanishi, Y. Demura, S. Mizuno, S. Ameshima, Y. Chiba, I. Miyamori, H. Itoh, M. Kitaichi, and T. Ishizaki Changes in HRCT findings in patients with respiratory bronchiolitis-associated interstitial lung disease after smoking cessation Eur. Respir. J., March 1, 2007; 29(3): 453 - 461. [Abstract] [Full Text] [PDF]

				R O'Donnell, D Breen, S Wilson, and R Djukanovic Inflammatory cells in the airways in COPD Thorax, May 1, 2006; 61(5): 448 - 454. [Abstract] [Full Text] [PDF]

				W. R. Webb Thin-Section CT of the Secondary Pulmonary Lobule: Anatomy and the Image--The 2004 Fleischner Lecture Radiology, May 1, 2006; 239(2): 322 - 338. [Abstract] [Full Text] [PDF]

				C. E. Girod and T. E. King Jr. COPD: A Dust-Induced Disease? Chest, October 1, 2005; 128(4): 3055 - 3064. [Abstract] [Full Text] [PDF]

				D. A. Lynch, W. D. Travis, N. L. Muller, J. R. Galvin, D. M. Hansell, P. A. Grenier, and T. E. King Jr Idiopathic Interstitial Pneumonias: CT Features Radiology, July 1, 2005; 236(1): 10 - 21. [Abstract] [Full Text] [PDF]

				S. B. Shaker, N. Maltbaek, P. Brand, S. Haeussermann, and A. Dirksen Quantitative computed tomography and aerosol morphometry in COPD and {alpha}1-antitrypsin deficiency Eur. Respir. J., January 1, 2005; 25(1): 23 - 30. [Abstract] [Full Text] [PDF]

				N L Muller and H Coxson Chronic obstructive pulmonary disease * 4: Imaging the lungs in patients with chronic obstructive pulmonary disease Thorax, November 1, 2002; 57(11): 982 - 985. [Abstract] [Full Text] [PDF]

				D.M. Hansell Small airways diseases: detection and insights with computed tomography Eur. Respir. J., June 1, 2001; 17(6): 1294 - 1313. [Abstract] [Full Text] [PDF]

				I. Mastora, M. Remy-Jardin, A. Sobaszek, C. Boulenguez, J. Remy, and J.-L. Edme Thin-Section CT Finding in 250 Volunteers: Assessment of the Relationship of CT Findings with Smoking History and Pulmonary Function Test Results Radiology, March 1, 2001; 218(3): 695 - 702. [Abstract] [Full Text]

				J. Moon, R. M du Bois, T. V Colby, D. M Hansell, and A. G Nicholson Clinical significance of respiratory bronchiolitis on open lung biopsy and its relationship to smoking related interstitial lung disease Thorax, November 1, 1999; 54(11): 1009 - 1014. [Abstract] [Full Text]

				M. Remy-Jardin, J.-L. Edme, C. Boulenguez, J. Remy, I. Mastora, and A. Sobaszek Longitudinal Follow-up Study of Smoker's Lung with Thin-Section CT in Correlation with Pulmonary Function Tests Radiology, January 1, 2002; 222(1): 261 - 270. [Abstract] [Full Text] [PDF]