From the Radiologic Pathology Archives Organization and Fibrosis as a Response to Lung Injury in Diffuse Alveolar Damage, Organizing Pneumonia, and Acute Fibrinous and Organizing Pneumonia
From the Radiologic Pathology Archives Organization and Fibrosis as a Response to Lung Injury in Diffuse Alveolar Damage, Organizing Pneumonia, and Acute Fibrinous and Organizing Pneumonia
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DOI：
10.1148/rg.337130057
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发表时间：
2013-11-01
期刊：
影响因子：
5.5
通讯作者：
Galvin, Jeffrey R.
中科院分区：
文献类型：
--
作者：
Kligerman, Seth J.;Franks, Teri J.;Galvin, Jeffrey R.
无论是局灶性还是弥漫性肺损伤，以成纤维细胞增殖为特征的组织是一种常见且几乎普遍的反应。尽管损伤因子的范围很广，但肺对损伤的反应是相当有限的，无论潜在原因如何，放射学和组织学上的反应模式相似。尽管有将组织划分为不同实体的倾向，但肺泡上皮基底膜的潜在损伤是这些过程中的一个统一因素。这种肺损伤模式见于弥漫性肺泡损伤的组织期、组织性肺炎（OP）、急性纤维性和组织性肺炎以及某些类型的纤维化肺病。此外，尽管组织可以在没有明显损伤的情况下愈合，但在某些情况下，它会发展为纤维化，这可能是严重的。当组织纤维化存在时，可出现其他组织学和影像学模式，如非特异性间质性肺炎，反映纤维化可能是组织的后遗症。本文回顾了弥漫性肺泡损伤、OP、急性纤维性肺炎和组织性肺炎引起的肺损伤的组织学和影像学表现，并帮助放射科医生了解组织学和影像学表现取决于损伤程度和随后的愈合反应。(c) rsna, 2013。radiographics.rsna.org
Organization, characterized by fibroblast proliferation, is a common and nearly universal response to lung injury whether it is focal or diffuse. Despite the vast range of injurious agents, the lung's response to injury is quite limited, with a similar pattern of reaction seen radiologically and histologically regardless of the underlying cause. Although there is a tendency to divide organization into distinct entities, the underlying injury to the alveolar epithelial basement membrane is a uniting factor in these processes. This pattern of lung injury is seen in the organizing phase of diffuse alveolar damage, organizing pneumonia (OP), acute fibrinous and organizing pneumonia, and certain types of fibrotic lung disease. In addition, although organization can heal without significant injury, in some instances it progresses to fibrosis, which can be severe. When fibrosis due to organization is present, other histologic and imaging patterns, such as those seen in nonspecific interstitial pneumonia, can develop, reflecting that fibrosis can be a sequela of organization. This article reviews the histologic and radiologic findings of organization in lung injury due to diffuse alveolar damage, OP, and acute fibrinous and organizing pneumonia and helps radiologists understand that the histologic and radiologic findings depend on the degree of injury and the subsequent healing response. (C)RSNA, 2013 . radiographics.rsna.org