Dados do Trabalho

Título

Thoracic Imaging: Identifying Interstitial Lung Abnormalities

Introdução e objetivo(s)

Interstitial Lung Abnormality (ILA) corresponds to the incidental finding in patients without clinical symptoms or deterioration of lung function. It presents as a series of anomalies affecting more than 5% of the area in at least one of the three lung zones on CT images. Its prevalence ranges from 0.8% to 22.8% in smokers and between 2% and 7% in non-smokers.

Common findings in ILA include ground-glass opacities, reticulation, architectural distortion, traction bronchiectasis, honeycombing pattern, and non-emphysematous cysts. High-resolution CT is a fundamental diagnostic tool, with a sensitivity of 93% and specificity of 73% for detecting interstitial lung disease. ILAs are more frequent in older adults, smokers (prevalence of 4-9% in smokers over 60 years and 2-7% in non-smokers), and those exposed to environmental smoke and genetic factors.

They are classified according to distribution and presence of fibrosis into non-subpleural, subpleural non-fibrotic, and subpleural fibrotic. Timely diagnosis is crucial as progression of images is estimated at 20% in 2 years and 73% in 5 years, leading to increased respiratory symptoms, reduced total lung capacity, gas exchange impairment, increased mortality, and higher risk of lung cancer.

Método(s)

We conducted a pictorial essay to highlight the relevance and impact of Interstitial Lung Abnormalities (ILA) regarding their radiologic image and clinical features, accompanied by pictorial support of representative cases.

Discussão

While previously considered insignificant abnormalities, it is now recommended for radiologists to include ILA findings in their reports. Despite advancements, challenges persist in understanding and standardizing the reporting of this pathology. The current definition in the Fleischner Society’s Glossary Terms is preliminary and requires a more robust assessment of its reproducibility. Another key question is the relationship between ILA and the subsequent development of idiopathic pulmonary fibrosis, still to be evaluated through histopathological correlation studies.

Conclusões

In summary, ILAs represent a significant clinical challenge due to their heterogeneity and complexity. A multidisciplinary approach integrating clinical, imaging, and timely management is crucial to optimize care for patients with these diseases.

Palavras Chave

Interstitial Lung Abnormalities; Thoracic Imaging

Arquivos