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- Original Article -

Histological Changes Are Background Factors in Acute Exacerbation of Usual Interstitial Pneumonia Pattern/Lesions Following Lung Resection

Yoshinori Kawabata¹, Eishin Hoshi², Mikio Ubukata³, Noboru Takayanagi³, Yutaka Sugita³, Katsuhiko Aoyama⁴, Tsutomu Yamada⁵, Kenji Uehara⁶, Tomohiko Mizutani^6
1Division of Pathology, ²Department of Internal Medicine, ³Department of Thoracic Surgery, Saitama Cardiovascular and Respiratory Center, Japan, ⁴NHO Higashisaitama Hospital, Japan, ⁵Department of Pathology, ⁶Department of Neurology, Nihon University School of Medicine, Japan

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Objective. The objective was to determine the histological features related to acute exacerbation of usual interstitial pneumonia pattern (UIP lesion). Materials and methods. The subjects were 12 patients with a diffuse (dense fibrosis extending more than 1 cm from the pleura) or a focal (less than 1 cm) UIP lesion showing acute exacerbation following lobectomy or more for lung cancer (exacerbation group), and 24 comparable patients without acute exacerbation (stable group). The exacerbation group: all men, mean±SD 68±7 years, 7 diffuse and 5 focal UIP lesions. We quantitatively examined the activity and tissue damage related to the UIP lesion on 3 representative histological slides by hematoxylin and eosin staining and by immunohistochemical staining using anti-EMA antibody and anti-ubiquitin antibody. Results. Significant differences (<0.05) were demonstrated: a. the thickness of interstitial inflammation continuous with dense fibrosis; exacerbation group 2.4±1.3, stable group 1.3±1.3 mm, b. number of granulation tissue in and next to dense fibrosis; 21.4±12.2, 12.6±9.1, c. quantification of interstitial inflammatory change with granulation tissue apart from dense fibrosis; 7±5.9, 3.7±3, d. quantification of acute interstitial inflammatory change with fibrin exudation; 1.6±3.2, 0.25±0.6, respectively. Conclusion. The above findings suggestive of UIP activities might be background factors in acute exacerbation.
key words: Usual interstitial pneumonia, Acute exacerbation, Lung cancer, Lobectomy

Received: January 13, 2006
Accepted: June 19, 2006

JJLC 46 (4): 329-336, 2006