Interstitial Lung Abnormalities: Poor Prognosis for Patients with Lung Cancer.
Radiology. 2019 Jun 4:190969. doi: 10.1148/radiol.2019190969. [Epub ahead of print]
With the increased use of chest CT in both asymptomatic and symptomatic individuals, more incidental findings are being detected. With the accumulation of data, our understanding about the clinical significance of these findings is evolving. Development of a fibrotic component in the lung at CT has been regarded as part of normal aging. This idea was indirectly supported by a study by Copley et al (1), who found a subpleural basal reticular pattern in 60% (24 of 40) of asymptomatic elderly individuals older than 75 years of age and in no individuals younger than 55 years of age.
The term interstitial lung abnormalities (ILAs) was coined in a study by Washko et al (2). They defined ILAs as nondependent changes affecting more than 5% of any lung zone, including nondependent ground-glass or reticular abnormalities, diffuse centrilobular nodularity, nonemphysematous cysts, honeycombing, and traction bronchiectasis. ILAs are increasingly recognized and reported in older individuals, with an incidence of 4%–9% in smokers and 2%–7% in nonsmokers (3). A subsequent study by Putman et al (4) has shown that ILAs were associated with a greater risk of all-cause mortality in four different cohorts: the Framingham Heart Study (n = 2633), the AGES-Reykjavik Study (n = 5320), the COPDGene Study (n = 2068), and the ECLIPSE Study (n = 1670).
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