Diffuse parenchymal lung diseases, clinical features, radiological findings and the diagnostic yield of open lung biopsy

ABSTRACT

Diffuse parenchymal lung diseases are rare, poorly understood and had not been studied in Iraq. To evaluate the clinical features and radiological findings of diffuse parenchymal lung diseases in relation to open lung biopsy. Twenty eight patients who were suspected to have diffuse parenchymal lung diseases [regarding clinical features, pulmonary function testing, chest-x-ray and conventional computed tomography findings] were recruited from Baghdad Teaching Hospital from the 1[st]. Jan 2006 to 3O[th] June 2011 and were subjected to open lung biopsies which had been histopathologically studied. There were 16 [57%] males and 12 [43%] females, the mean age was 43.1 +/- 1.5 years, progressive dyspnea was the common presenting symptoms in22 patients [78.6%], dry cough was the presenting symptoms in 6 [21.4%] patients, restrictive lung defect was present in26 [92.9%] patients, bilateral fine basal crepetations were heared in 24 [85.7%] patients, clubbing of fingers was present in 17 [60.7%] patients, chest-x- rays findings were 24[85 .7%] patients had mainly lower zone involvement and 18[64.3%] patients had reticular infiltrate. CT findings were 20[71.4%] patients had basal infiltrate and 11[39.3%] patients had subpleural involvement. Open lung biopsy results were 11 [39.3%] patients had usual interstitial pneumonia [idiopathic pulmonary fibrosis], 7 [25%] patients had desquamative interstitial pneumonia, and 2[7.1%] patients had nonspecific interstitial pneumonia 2 [7.1%] patients had non caseating granulomas. Dyspnea on excertion was a common presenting symptom. Bilateral fine basal crepetations were a common physical finding. Restrictive lung defect was the major finding in pulmonary function testing. Lower zone and basal infiltrates were common findings in chest-x-rays and conventional computed tomographies respectively. Idiopathic pulmonary fibrosis [usual interstitial pneumonia] was the most common type of diffuse parenchymal lung diseases, followed by desquamative interstitial pneumonia. Open lung biopsy gave a high diagnostic yield