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Serial High-Resolution Computed Tomography Findings of Acute and Chronic Hypersensitivity Pneumonitis Induced by Avian Antigen

Tateishi, Tomoya MD*; Ohtani, Yoshio MD*; Takemura, Tamiko MD†; Akashi, Takumi MD‡; Miyazaki, Yasunari MD*; Inase, Naohiko MD*; Yoshizawa, Yasuyuki MD, PhD*

Journal of Computer Assisted Tomography: March/April 2011 - Volume 35 - Issue 2 - pp 272-279
doi: 10.1097/RCT.0b013e318209c5a6
Thoracic Imaging

Purpose: The purpose of this study was to evaluate serial changes and the prognostic value of high-resolution computed tomographic (HRCT) findings in hypersensitivity pneumonitis (HP).

Method: The medical records of 112 patients with bird-related HP (17 acute, 33 recurrent, and 62 insidious) were retrospectively reviewed. High-resolution computed tomographic findings at the time of diagnosis and at follow-up were retrospectively interpreted.

Results: Ground-glass opacities and centrilobular nodules were predominant findings in acute and recurrent HP, whereas honeycombing was the outstanding feature in insidious HP. Areas of ground-glass opacities and centrilobular nodules decreased in all groups over a long-term follow-up. Areas of honeycombing, on the other hand, increased in chronic HP, especially in the insidious cases. Cox regression models revealed a higher mortality risk in cases with airspace consolidation and honeycombing on HRCT.

Conclusion: Acute, recurrent, and insidious HP all have characteristic features on CT. Characteristic HRCT findings can predict the prognosis of chronic HP.

From the *Department of Integrated Pulmonology, Tokyo Medical and Dental University; †Department of Pathology, Japan Red Cross Center; and ‡Department of Pathology, Tokyo Medical and Dental University, Tokyo, Japan.

Received for publication October 29, 2010; accepted November 23, 2010.

Reprints: Yasuyuki Yoshizawa, MD, PhD, Department of Integrated Pulmonology, Tokyo Medical and Dental University, 5-45, Yushima 1-chome, Bunkyo-ku, Tokyo 113-8519, Japan (e-mail: yoshizawa.pulm@tmd.ac.jp).

This work was supported by the Research on Health Sciences focusing on Drug Innovation, and Charitable Trust of Okamoto Satoshi Fund for Fibrotic Lung Disorders.

© 2011 Lippincott Williams & Wilkins, Inc.