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

Jpn J Radiol. 2019 Mar;37(3):230-236. doi: 10.1007/s11604-018-0805-5. Epub 2019 Jan 1.

Abstract

Purpose: 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.

Results: 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.

Conclusion: 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.

Keywords: Apical cap; Computed tomography; Interstitial pneumonia; Lung; Pleuroparenchymal fibroelastosis.

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Body Mass Index
  • Disease Progression
  • Female
  • Follow-Up Studies
  • Humans
  • Lung Diseases / diagnostic imaging*
  • Lung Diseases / pathology
  • Male
  • Middle Aged
  • Pleura / diagnostic imaging*
  • Pleura / pathology*
  • Retrospective Studies
  • Tomography, X-Ray Computed / methods*
  • Young Adult