Idiopathic pleuroparenchymal fibroelastosis: Consideration of a clinicopathological entity in a series of Japanese patients

Hideki Kusagaya, Yutaro Nakamura, Masato Kono, Yusuke Kaida, Shigeki Kuroishi, Noriyuki Enomoto, Tomoyuki Fujisawa, Naoki Koshimizu, Koshi Yokomura, Naoki Inui, Takafumi Suda, Thomas V. Colby, Kingo Chida

Research output: Contribution to journalArticle

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Abstract

Background: Idiopathic pleuroparenchymal fibroelastosis (IPPFE) is a recently reported group of disorders characterized by fibrotic thickening of the pleural and subpleural parenchyma predominantly in the upper lobes. We report five Japanese cases fulfilling the criteria of IPPFE and address whether it should be considered a separate clinicopathologic entity. And this study was an attempt to identify features in common between IPPFE and previously described idiopathic upper lobe fibrosis (IPUF), allowing IPPFE to be considered as a distinct entity in our Japanese series.Methods: Five consecutive cases of idiopathic interstitial lung disease confirmed as IPPFE by surgical lung biopsy were studied.Results: There were four males and one female, aged 70±2.76 yr. No associated disorder or presumed cause was found in any case. Lung function tests found a restrictive ventilatory defect (4/5) and/or impairment of DLco (4/5). Chest X-ray showed marked apical pleural thickening in all cases. Computed tomography of the chest in all cases mainly showed intense pleural thickening and volume loss associated with evidence of fibrosis, predominantly in the upper lobes. In all cases in this study, markedly thickened visceral pleura and prominent subpleural fibrosis characterized by both elastic tissue and dense collagen were clearly shown. All cases were alive at the last follow-up, 17.6±13.59 months after diagnosis; however, all had deteriorated both clinically and radiologically.Conclusions: IPPFE deserves to be defined as a separate, original clinicopathologic entity owing to its uniformity and IPPFE has some features in common with previously described idiopathic upper lobe fibrosis (IPUF). Our limited experience with a cohort of 5 subjects suggests that IPPFE can be rapidly progressive.

Original languageEnglish (US)
Article number72
JournalBMC Pulmonary Medicine
Volume12
DOIs
StatePublished - Dec 5 2012

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Fibrosis
Thorax
Elastic Tissue
Pleura
Respiratory Function Tests
Interstitial Lung Diseases
Collagen
Tomography
X-Rays
Biopsy
Lung

Keywords

  • Fibroelastosis
  • Idiopathic interstitial lung disease
  • Pleural fibrosis
  • Pleuroparenchymal fibroelastosis

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Idiopathic pleuroparenchymal fibroelastosis : Consideration of a clinicopathological entity in a series of Japanese patients. / Kusagaya, Hideki; Nakamura, Yutaro; Kono, Masato; Kaida, Yusuke; Kuroishi, Shigeki; Enomoto, Noriyuki; Fujisawa, Tomoyuki; Koshimizu, Naoki; Yokomura, Koshi; Inui, Naoki; Suda, Takafumi; Colby, Thomas V.; Chida, Kingo.

In: BMC Pulmonary Medicine, Vol. 12, 72, 05.12.2012.

Research output: Contribution to journalArticle

Kusagaya, H, Nakamura, Y, Kono, M, Kaida, Y, Kuroishi, S, Enomoto, N, Fujisawa, T, Koshimizu, N, Yokomura, K, Inui, N, Suda, T, Colby, TV & Chida, K 2012, 'Idiopathic pleuroparenchymal fibroelastosis: Consideration of a clinicopathological entity in a series of Japanese patients', BMC Pulmonary Medicine, vol. 12, 72. https://doi.org/10.1186/1471-2466-12-72
Kusagaya, Hideki ; Nakamura, Yutaro ; Kono, Masato ; Kaida, Yusuke ; Kuroishi, Shigeki ; Enomoto, Noriyuki ; Fujisawa, Tomoyuki ; Koshimizu, Naoki ; Yokomura, Koshi ; Inui, Naoki ; Suda, Takafumi ; Colby, Thomas V. ; Chida, Kingo. / Idiopathic pleuroparenchymal fibroelastosis : Consideration of a clinicopathological entity in a series of Japanese patients. In: BMC Pulmonary Medicine. 2012 ; Vol. 12.
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AU - Kono, Masato

AU - Kaida, Yusuke

AU - Kuroishi, Shigeki

AU - Enomoto, Noriyuki

AU - Fujisawa, Tomoyuki

AU - Koshimizu, Naoki

AU - Yokomura, Koshi

AU - Inui, Naoki

AU - Suda, Takafumi

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N2 - Background: Idiopathic pleuroparenchymal fibroelastosis (IPPFE) is a recently reported group of disorders characterized by fibrotic thickening of the pleural and subpleural parenchyma predominantly in the upper lobes. We report five Japanese cases fulfilling the criteria of IPPFE and address whether it should be considered a separate clinicopathologic entity. And this study was an attempt to identify features in common between IPPFE and previously described idiopathic upper lobe fibrosis (IPUF), allowing IPPFE to be considered as a distinct entity in our Japanese series.Methods: Five consecutive cases of idiopathic interstitial lung disease confirmed as IPPFE by surgical lung biopsy were studied.Results: There were four males and one female, aged 70±2.76 yr. No associated disorder or presumed cause was found in any case. Lung function tests found a restrictive ventilatory defect (4/5) and/or impairment of DLco (4/5). Chest X-ray showed marked apical pleural thickening in all cases. Computed tomography of the chest in all cases mainly showed intense pleural thickening and volume loss associated with evidence of fibrosis, predominantly in the upper lobes. In all cases in this study, markedly thickened visceral pleura and prominent subpleural fibrosis characterized by both elastic tissue and dense collagen were clearly shown. All cases were alive at the last follow-up, 17.6±13.59 months after diagnosis; however, all had deteriorated both clinically and radiologically.Conclusions: IPPFE deserves to be defined as a separate, original clinicopathologic entity owing to its uniformity and IPPFE has some features in common with previously described idiopathic upper lobe fibrosis (IPUF). Our limited experience with a cohort of 5 subjects suggests that IPPFE can be rapidly progressive.

AB - Background: Idiopathic pleuroparenchymal fibroelastosis (IPPFE) is a recently reported group of disorders characterized by fibrotic thickening of the pleural and subpleural parenchyma predominantly in the upper lobes. We report five Japanese cases fulfilling the criteria of IPPFE and address whether it should be considered a separate clinicopathologic entity. And this study was an attempt to identify features in common between IPPFE and previously described idiopathic upper lobe fibrosis (IPUF), allowing IPPFE to be considered as a distinct entity in our Japanese series.Methods: Five consecutive cases of idiopathic interstitial lung disease confirmed as IPPFE by surgical lung biopsy were studied.Results: There were four males and one female, aged 70±2.76 yr. No associated disorder or presumed cause was found in any case. Lung function tests found a restrictive ventilatory defect (4/5) and/or impairment of DLco (4/5). Chest X-ray showed marked apical pleural thickening in all cases. Computed tomography of the chest in all cases mainly showed intense pleural thickening and volume loss associated with evidence of fibrosis, predominantly in the upper lobes. In all cases in this study, markedly thickened visceral pleura and prominent subpleural fibrosis characterized by both elastic tissue and dense collagen were clearly shown. All cases were alive at the last follow-up, 17.6±13.59 months after diagnosis; however, all had deteriorated both clinically and radiologically.Conclusions: IPPFE deserves to be defined as a separate, original clinicopathologic entity owing to its uniformity and IPPFE has some features in common with previously described idiopathic upper lobe fibrosis (IPUF). Our limited experience with a cohort of 5 subjects suggests that IPPFE can be rapidly progressive.

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