Produção Nacional
Revisado por pares
Computed tomography in hypersensitivity pneumonitis: main findings, differential diagnosis and pitfalls
2017; Taylor & Francis; Volume: 12; Issue: 1 Linguagem: Inglês
10.1080/17476348.2018.1395282
ISSN1747-6356
AutoresOlívia Meira Dias, Bruno Guedes Baldi, Francesca Pennati, Andréa Aliverti, Rodrigo Caruso Chate, Márcio Valente Yamada Sawamura, Carlos Roberto Ribeiro de Carvalho, André Luís Pereira de Albuquerque,
Tópico(s)Occupational and environmental lung diseases
ResumoHypersensitivity pneumonitis (HP) is a disease with variable clinical presentation in which inflammation in the lung parenchyma is caused by the inhalation of specific organic antigens or low molecular weight substances in genetically susceptible individuals. Alterations of the acute, subacute and chronic forms may eventually overlap, and the diagnosis based on temporality and presence of fibrosis (acute/inflammatory HP vs. chronic HP) seems to be more feasible and useful in clinical practice. Differential diagnosis of chronic HP with other interstitial fibrotic diseases is challenging due to the overlap of the clinical history, and the functional and imaging findings of these pathologies in the terminal stages. Areas covered: This article reviews the essential features of HP with emphasis on imaging features. Moreover, the main methodological limitations of high-resolution computed tomography (HRCT) interpretation are discussed, as well as new perspectives with volumetric quantitative CT analysis as a useful tool for retrieving detailed and accurate information from the lung parenchyma. Expert commentary: Mosaic attenuation is a prominent feature of this disease, but air trapping in chronic HP seems overestimated. Quantitative analysis has the potential to estimate the involvement of the pulmonary parenchyma more accurately and could correlate better with pulmonary function results.
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