The Journal of the Japanese Respiratory Society ONLINE JOURNAL
ABSTRACT
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Article in Japanese
Original Article
Clinicopathological Analysis of Patients with Idiopathic Pulmonary Fibrosis which Became Acutely Exacerbated after Video-Assisted Thoracoscopic Surgical Lung Biopsy
Tatsuji Enomoto1), Masashi Kawamoto2), Shinobu Kunugi2), Kumiko Hiramatsu1), Keitaro Sakakibara1), Jiro Usuki1), Arata Azuma1), Kyoji Hirai3), Kiyoshi Koizumi3), Yuh Fukuda2) and Shoji Kudoh1)
Fourth Department of Internal Medicine1), First Department of Pathology2), Second Department of Surgery3), Nippon Medical School, 1-1-5 Sendagi Bunkyo-ku Tokyo 113-8603, Japan
ABSTRACT
Nine patients undergoing video-assisted thoracoscopic surgical (VATS) lung biopsy over a five-year period from 1997 to 2001 with the ultimate diagnosis of usual interstitial pneumonia without underlying connective tissue disease were identified. In two of nine patients, acute exacerbation occurred six days after VATS lung biopsy. We reviewed the clinical records and pathology of all nine cases, and found that the two cases of exacerbation had higher peripheral white blood cell counts and KL-6, lower PaO2, VC and FEV1, and a longer inhalation of FIO2=1.0 during VATS, and needed a longer period of chest drainage after VATS. Abundant inflammatory cell infiltration and fibroblastic foci were observed in the exacerbation cases. Thus, patients with usual interstitial pneumonia of the idiopathic type, who have high disease activity and low pulmonary function, may be at high risk of acute exacerbation following VATS lung surgery.
KEYWORDS: Idiopathic pulmonary fibrosis, Usual interstitial pneumonia, Video-assisted thoracoscopic surgical lung biopsy, Acute exacerbation
RECEIVED: 2002.6.13
JJRS, 40(10): 806-811, 2002
