각종 간질성폐질환에서 폐포 대식세포의 Superoxide 분비능과 식균 작용

송정섭(Jeong Sup Song),김영균(Young Kyoon Kim),김관형(Kwan Hyoung Kim),한기돈(Ki Don Han),문화식(Hwa Sik Moon),신완식(Wan Shik Shin),박성학(Sung Hak Park) 대한내과학회 1990 대한내과학회지 Vol.39 No.3

N/A Interstitial lung diseases are a heterogenous group of disorders characterized by various degrees of parenchymal alveolitis and fibrosis. Alveolar macrophages (AM) are the predominant inflammatory cell type within alveolar structures and function not only as phagocytic cells but also as secretory cells that release various secretory products involving oxygen metabolites. Alveolar macrophages from patients with interstitial lung disease are thought to participate in the injury to the alveolar wall and contribute to the development of interstitial fibrosis. To investigate the role of alveolar macrophages in interstitial lung diseases, we measured the amount of superoxide release and phagocytosis by AM after bronchoalveolar lavage (BAL) from the normal controls and cases with interstitial lung diseases. The results were summerized as follows: 1) The total number of inflammatory cells in the BAL fluids increased more in patients with interstitial lung diseases than in the controls (p<0.02). 2) The differential cell count of BAL inflammatory cells showed that lymphocytes were predominant in sarcoidosis, hypersensitivity pneumonitis, and collagen lung disease, while neutrophils were predominant in idiopathic pulmonary fibrosis and bleomycin-induced pneumonitis. 3) The superoxide release by AM in patients with interstitial lung diseases was higher than the normal controls, either spontaneously or after stimulation by phorbol myristate acetate (PMA)(p<0.05). 4) The phagocytosis of non-opsonized staphylococcus aureus by AM was elevated in the interstitial lung disease cases (p<0.02), but no difference was noted when using the opsonized staphylococcus aureus as a target. These results suggest that AM are activated in interstitial lung diseases, and increased production of oxidant by AM in interstitial lung diseases may play a critical role in tissue damage and pulmonary fibrosis. Elevation of oxygen metabolite release by AM could be a useful marker in the assessment of the activity of interstitial lung diseases.

만성 간질성 폐질환의 병리

신동환 대한병리학회 1998 Journal of Pathology and Translational Medicine Vol.32 No.1

Interstitial Lung Disease and Lung Cancer Development: A 5-Year Nationwide Population-Based Study

최원일,박순효,박병주,이충원 대한암학회 2018 Cancer Research and Treatment Vol.50 No.2

Purpose In this nationwide 5-year longitudinal population-based study, we aimed at investigating the incidence of lung cancer among patients with interstitial lung disease. Materials and Methods Data was collected from the Korean National Health Insurance Research Database from 49,773,195 Korean residents in 2009. Thirteen thousand six hundred and sixty-six patients with interstitial lung disease diagnosed January-December 2009. The end of follow-up was June 30, 2014. Up to four matching chronic obstructive pulmonary disease controls were selected to compare the lung cancer high-risk group based on age, sex, diagnosis date (within 30 days), and hospital size. The number of patients with newly developed lung cancer was determined. Results The incidences of lung cancer were 126.98, 156.62, and 370.38 cases per 10,000 person- years (2,732, 809, and 967 cases of cancer, respectively) in the chronic obstructive pulmonary disease, interstitial lung disease, and chronic obstructive pulmonary disease with interstitial lung disease groups, respectively. Of the 879 patients with idiopathic pulmonary fibrosis, 112 developed lung cancer (incidence, 381.00 cases per 10,000 personyears). Conclusion Incidence of lung cancer among patients with interstitial lung disease was high. Interstitial lung diseases have a high potential for developing into lung cancer, even when concurrent with chronic obstructive pulmonary disease.

CASE REPORT : A Case of IgG4-Related Lung Disease Presenting as Interstitial Lung Disease

( Jee Hwan Ahn ),( Sun In Hong ),( Dong Hui Cho ),( Eun Jin Chae ),( Joon Seon Song ),( Jin Woo Song ) 대한결핵 및 호흡기학회 2014 Tuberculosis and Respiratory Diseases Vol.77 No.2

Intrathoracic involvement of immunoglobulin G4 (IgG4)-related disease has recently been reported. However, a subset of the disease presenting as interstitial lung disease is rare. Here, we report a case of a 35-year-old man with IgG4-related lung disease with manifestations similar to those of interstitial lung disease. Chest computed tomography showed diffuse ground glass opacities and rapidly progressive pleural and subpleural fibrosis in both upper lobes. Histological findings showed diffuse interstitial lymphoplasmacytic infiltration with an increased number of IgG4-positive plasma cells. Serum levels of IgG and IgG4 were also increased. The patient was diagnosed with IgG4-related lung disease, treated with anti-inflammatory agents, and showed improvement. Lung involvement of IgG4-related disease can present as interstitial lung disease and, therefore, should be differentiated when evaluating interstitial lung disease.

A Case of IgG4-Related Lung Disease Presenting as Interstitial Lung Disease

안재환,송진우,홍선인,조동휘,채은진,송준선 대한결핵및호흡기학회 2014 Tuberculosis and Respiratory Diseases Vol.77 No.2

Intrathoracic involvement of immunoglobulin G4 (IgG4)-related disease has recently been reported. However, a subset of the disease presenting as interstitial lung disease is rare. Here, we report a case of a 35-year-old man with IgG4-related lung disease with manifestations similar to those of interstitial lung disease. Chest computed tomography showed diffuse ground glass opacities and rapidly progressive pleural and subpleural fibrosis in both upper lobes. Histological findings showed diffuse interstitial lymphoplasmacytic infiltration with an increased number of IgG4-positive plasma cells. Serum levels of IgG and IgG4 were also increased. The patient was diagnosed with IgG4-related lung disease, treated with anti-inflammatory agents, and showed improvement. Lung involvement of IgG4-related disease can present as interstitial lung disease and, therefore, should be differentiated when evaluating interstitial lung disease.

Pathological interpretation of connective tissue disease-associated lung diseases

Kun Young Kwon 영남대학교 의과대학 2019 Yeungnam University Journal of Medicine Vol.36 No.1

Connective tissue diseases (CTDs) can affect all compartments of the lungs, including airways, alveoli, interstitium, vessels, and pleura. CTD-associated lung diseases (CTD-LDs) may present as diffuse lung disease or as focal lesions, and there is significant heterogeneity between the individual CTDs in their clinical and pathological manifestations. CTD-LDs may presage the clinical diagnosis a primary CTD, or it may develop in the context of an established CTD diagnosis. CTD-LDs reveal acute, chronic or mixed pattern of lung and pleural manifestations. Histopathological findings of diverse morphological changes can be present in CTD-LDs airway lesions (chronic bronchitis/bronchiolitis, follicular bronchiolitis, etc.), interstitial lung diseases (nonspecific interstitial pneumonia/fibrosis, usual interstitial pneumonia, lymphocytic interstitial pneumonia, diffuse alveolar damage, and organizing pneumonia), pleural changes (acute fibrinous or chronic fibrous pleuritis), and vascular changes (vasculitis, capillaritis, pulmonary hemorrhage, etc.). CTD patients can be exposed to various infectious diseases when taking immunosuppressive drugs. Histopathological patterns of CTD-LDs are generally nonspecific, and other diseases that can cause similar lesions in the lungs must be considered before the diagnosis of CTD-LDs. A multidisciplinary team involving pathologists, clinicians, and radiologists can adequately make a proper diagnosis of CTD-LDs.

A Case of IgG4-Related Lung Disease Presenting as Interstitial Lung Disease

Ahn, Jee Hwan,Hong, Sun In,Cho, Dong Hui,Chae, Eun Jin,Song, Joon Seon,Song, Jin Woo The Korean Academy of Tuberculosis and Respiratory 2014 Tuberculosis and Respiratory Diseases Vol.77 No.2

Intrathoracic involvement of immunoglobulin G4 (IgG4)-related disease has recently been reported. However, a subset of the disease presenting as interstitial lung disease is rare. Here, we report a case of a 35-year-old man with IgG4-related lung disease with manifestations similar to those of interstitial lung disease. Chest computed tomography showed diffuse ground glass opacities and rapidly progressive pleural and subpleural fibrosis in both upper lobes. Histological findings showed diffuse interstitial lymphoplasmacytic infiltration with an increased number of IgG4-positive plasma cells. Serum levels of IgG and IgG4 were also increased. The patient was diagnosed with IgG4-related lung disease, treated with anti-inflammatory agents, and showed improvement. Lung involvement of IgG4-related disease can present as interstitial lung disease and, therefore, should be differentiated when evaluating interstitial lung disease.

Pathological interpretation of connective tissue disease-associated lung diseases

Kwon, Kun Young Yeungnam University College of Medicine 2019 Yeungnam University Journal of Medicine Vol.36 No.1

Connective tissue diseases (CTDs) can affect all compartments of the lungs, including airways, alveoli, interstitium, vessels, and pleura. CTD-associated lung diseases (CTD-LDs) may present as diffuse lung disease or as focal lesions, and there is significant heterogeneity between the individual CTDs in their clinical and pathological manifestations. CTD-LDs may presage the clinical diagnosis a primary CTD, or it may develop in the context of an established CTD diagnosis. CTD-LDs reveal acute, chronic or mixed pattern of lung and pleural manifestations. Histopathological findings of diverse morphological changes can be present in CTD-LDs airway lesions (chronic bronchitis/bronchiolitis, follicular bronchiolitis, etc.), interstitial lung diseases (nonspecific interstitial pneumonia/fibrosis, usual interstitial pneumonia, lymphocytic interstitial pneumonia, diffuse alveolar damage, and organizing pneumonia), pleural changes (acute fibrinous or chronic fibrous pleuritis), and vascular changes (vasculitis, capillaritis, pulmonary hemorrhage, etc.). CTD patients can be exposed to various infectious diseases when taking immunosuppressive drugs. Histopathological patterns of CTD-LDs are generally nonspecific, and other diseases that can cause similar lesions in the lungs must be considered before the diagnosis of CTD-LDs. A multidisciplinary team involving pathologists, clinicians, and radiologists can adequately make a proper diagnosis of CTD-LDs.

류마티스 관절염 환자에서 간질성 폐질환 유무에 대한 임상 양상의 비교

지종대 ( Jong Dae Ji ),이영호 ( Young Ho Lee ),송관규 ( Gwan Gyu Song ) 대한류마티스학회 1998 대한류마티스학회지 Vol.5 No.2

Objective: To determine the clinical, laboratory and radiologic factors related to interstitial lung disease in patients with rheumatoid arthritis. Method: 10 patients with rheumatoid arhritis and interstitial lung disease, and 20 patients with rheumatoid arthritis as controlled group were included in this study. Interstitial lung disease was diagnosed by pulmonary function test and high resolution computed tomography. We evaluated the importance of rheumatoid arthritis-specific factors on the interstitial lung disease. Results: 1) patients with interstitial lung disease(mean, 64.40±8.38) were older than those without interstitial lung disease(52.5±14.0). 2) The sex ratio, duration of disease and smoking history were similar between two groups. 3) The incidence of subcutaneous nodule(15 vs 0%, p<0.05) and sputum (15 vs 0%, p<0.05) was different between two groups. The number of joints with swelling(8.62±8.37 vs 3.25±1.59, p<0.05) and tenderness(14.1±10.1 vs 7.10±4.04, p<0.05) was different. But the incidence of cough, fever, dyspnea and chest pain was not different between two groups. 4) C-reactive protein(51.5±35.9mg/l vs 18.9±17.9mg/l, p<0.05) was different between two groups. Hematocrit, platelet, erythrocyte sedimentation rate, hand radiographic evidence of bone erosion was not different. Titer of rheumatoid factors(235±192IU/ml vs 115±158IU/ml, p=0.09) was different between two groups, but was not statistically significant. Conclusion: We found that the incidence of subcutaneous nodule, sputum, number of tenderness and swelling of the joints, C-reactive protein in group with interstitial lung disease was higher than group without interstitial lung disease.

Interstitial Lung Diseases: Respiratory Review of 2013

Kim, Yong Hyun,Kwon, Soon Seog The Korean Academy of Tuberculosis and Respiratory 2013 Tuberculosis and Respiratory Diseases Vol.75 No.2

Interstitial lung diseases are heterogeneous entities with diverse clinical presentations. Among them, idiopathic pulmonary fibrosis and connective tissue disease-associated interstitial lung disease are specific categories that pulmonologists are most likely to encounter in the clinical field. Despite the accumulated data from extensive clinical trial and observations, we continue to have many issues which need to be resolved in this field. In this update, we present the review of several articles regarding the clinical presentation, prognosis and treatment of patients with idiopathic pulmonary fibrosis or connective tissue disease-associated interstitial lung disease.