The Pathologic Findings In Diffuse Interstitial Fibrosis Of The Lungs

Our plain-English summary of The Pathologic Findings In Diffuse Interstitial Fibrosis Of The Lungs, by S.D. Greenberg, R.M. O'Neal, D.E. Jenkins (1974).

The study

• Authors: S.D. Greenberg, R.M. O'Neal, D.E. Jenkins
• Published: Southern Medical Journal 67(5):571-579, May (1974)
• Type of article: Journal article
• Our copy: from Johns-Manville's own medical library, J-M no. 003154. The article is still under copyright, so we describe it here rather than post it.

In plain English

This article was the authors' review of 23 cases of diffuse interstitial fibrosis of the lungs, a scarring of lung tissue, studied at Baylor College of Medicine Affiliated Hospitals in Houston from 1960 to 1972. Ten patients were men and 13 were women. Twenty-one had died and had autopsies, and nine had lung biopsies. Shortness of breath (dyspnea) was the first symptom, and 10 of the 23 patients developed clubbing of the fingers. A few had rheumatoid arthritis, lupus erythematosus, Raynaud's phenomenon or progressive systemic sclerosis. Chest X-rays showed progressive shadows in both lungs, most marked in the lower lobes. Lung function tests showed a restrictive defect. Survival after diagnosis ranged from 6 to 82 months, with a mean of 54 months. Most biopsies showed marked fibrosis of the 'usual interstitial pneumonia' pattern. One patient whose biopsy was taken early in the illness improved after corticosteroid treatment. The authors hoped that early biopsies studied by electron and fluorescence microscopy would allow a specific diagnosis more often. The article does not mention asbestos.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Case series: a review of the authors' collected cases, including clinical records, chest X-rays, lung function studies, biopsies and autopsies
• Who was studied: 23 patients with diffuse interstitial fibrosis of the lungs at Baylor College of Medicine Affiliated Hospitals, Houston, 1960 to 1972. 10 were men and 13 were women, aged 18 to 76 years (mean 52).
• Exposure: No exposure was studied. Asbestos and other fibers are not mentioned in the article.
• Main results:
  • 21 of the 23 patients had died, and all of these had autopsies. Nine patients had lung biopsies: four open and five percutaneous needle biopsies.
  • The initial symptom was dyspnea (shortness of breath).
  • 10 of the 23 patients showed digital clubbing.
  • Among the patients: one had rheumatoid arthritis, two had arthritic symptoms, two had lupus erythematosus, two had Raynaud's phenomenon, and one had progressive systemic sclerosis.
  • Chest X-rays showed progressive, bilateral, reticular, diffuse infiltrates, most marked in the lower lobes.
  • Pulmonary function tests showed a restrictive ventilatory defect.
  • Survival after diagnosis ranged from 6 to 82 months.
  • Mean survival after diagnosis for the 23 patients was 54 months.
  • In most biopsies the fibrosis was marked and of the usual interstitial pneumonia (UIP) pattern.
  • In one patient biopsied early in the illness, whose biopsy showed a desquamative interstitial pneumonia (DIP) pattern, the patient was greatly improved and the infiltrate had cleared after six months of corticosteroid therapy.
  • At autopsy, microcysts with areas of fibrosis were most marked in the basal segments of the lower lobes.
• The authors' conclusion: The authors hoped that lung biopsies done early in the disease and studied with electron and fluorescence microscopy would allow a specific diagnosis to be made more often.

Topics

Medical terms in this study, explained in our Lexicon: Interstitial Fibrosis, Dyspnea, Clubbing, Chest X-Ray, Fibrosis, Interstitial, Biopsy.

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