Chest
Clinical InvestigationsSmokingCT Assessment of Subtypes of Pulmonary Emphysema in Smokers
Section snippets
Materials
We reviewed 945 subjects (619 men and 326 women, ranging in age from 21 to 91 years) from the Kagawa Prefectural Cancer Detecting Center and Numakuma Hospital, who had undergone CT scanning between December 1997 and June 1999 because of suspected lung disease seen on chest radiographs or because of respiratory complaints. Because there were too few female smokers, only the data for male smokers were analyzed. PE was diagnosed by the presence of low-attenuation areas (LAAs) on CT scans and not
Results
Of 945 total subjects in the present study, there were only 41 (4.3%) with pulmonary disease other than PE (lung cancer, 10 subjects; interstitial pneumonia, 8 subjects; pneumoconiosis, 8 subjects; inflammatory change including tuberculosis, 9 subjects; and bronchiectasis, 6 subjects). PE was found in 270 of 516 male smokers (10 of 38 female smokers had PE). In male smokers, there were no statistically significant differences in cigarette consumption in number of pack-years according to CT
Discussion
CLE is by far the most common form of emphysema and has a proven association with cigarette smoking.15 PSE can occur as an isolated phenomenon in young adults.5 Bullae can develop in association with any type of PE but are most common with PSE or CLE. A bulla, by definition, is a sharply demarcated area of PE measuring≥ 1 cm in diameter and possessing a wall < 1 mm in thickness.6 PSE can occur in older patients with CLE.5
At least some degree of PE is recognized in more than half of Japanese
Conclusion
CLE (or CLE mixed with PSE) can be found in young subjects (ie, those ≤ 50 years of age), and even in those < 40 years of age. In older subjects (ie, those > 50 years of age), CLE predominates. Although PSE can occur in nonsmokers, both CLE and PSE are strongly related to smoking. Both types progress with age and the cumulative cigarette smoking dose. PE was found in more than half of male smokers. A high incidence of PE was found even in younger subjects.
References (16)
- et al.
Radiology of chronic obstructive pulmonary disease
Radiol Clin North Am
(1998) - et al.
Mass screening for lung cancer with mobile spiral computed tomography scanner
Lancet
(1998) - et al.
“Density mask”: an objective method to quantitate emphysema using computed tomography
Chest
(1988) - et al.
Quantitative chest computed tomography as a means of predicting exercise performance in severe emphysema
Acad Radiol
(1995) Chronic bronchitis, asthma, and pulmonary emphysema: statement by the Committee on Diagnostic Standards for Nontuberculous Respiratory Disease
Am Rev Respir Dis
(1962)- et al.
Pulmonary emphysema in smokers
Am J Respir Crit Care Med
(1999) - et al.
Emphysema: definition, imaging, and quantification
AJR Am J Roentgenol
(1995) - et al.
A clinical comparison between Technegas SPECT, CT, and pulmonary function tests in patients with emphysema
Radiat Med
(1997)
Cited by (56)
A Novel Nomogram and Risk Classification System Predicting Radiation Pneumonitis in Patients With Esophageal Cancer Receiving Radiation Therapy
2019, International Journal of Radiation Oncology Biology PhysicsCitation Excerpt :Specifically, clinicopathologic parameters included age, gender, Eastern Cooperative Oncology Group performance status, smoking index, diabetes history, Subjective Global Assessment score (SGA), pulmonary fibrosis score (PFS) and pulmonary emphysema score, baseline PFTs, pathologic diagnosis, tumor location and length, Tumor Node Metastasis (TNM) stage, RT technique, radiation dose, elective nodal irradiation, and chemotherapy. The SGA was used to evaluate patients’ nutritional status at the end of RT.18 The PFS and pulmonary emphysema score were assessed based on computer tomography (CT) pre-RT by the criteria of Kazerooni et al23 and Satoh et al,24 respectively. In terms of PFTs, commonly used objective measures such as percent predicted value of forced vital capacity (FVC%), percent predicted value of forced expiratory volume at 1 second (FEV1%), and diffusion capacity of lung for carbon monoxide (DLCO) were collected from baseline reports pre-RT.
Clinical-Radiologic-Pathologic Correlation of Smoking-Related Diffuse Parenchymal Lung Disease
2016, Radiologic Clinics of North AmericaCitation Excerpt :Emphysema is the most common radiologic finding associated with cigarette smoking and is defined as the permanent enlargement of the airspaces distal to the terminal bronchioles. Various subtypes of emphysema exist but CLE is the most common subtype and has a well-proven association with cigarette smoking.18,19 In CLE, more central alveoli adjacent to the small airways are dilated but the more peripheral alveoli adjacent to the septum that mark the boundary of the secondary pulmonary lobule are conspicuously spared (see Fig. 2).
Combined analysis of V20, VS5, pulmonary fibrosis score on baseline computed tomography, and patient age improves prediction of severe radiation pneumonitis after concurrent chemoradiotherapy for locally advanced non-small-cell lung cancer
2014, Journal of Thoracic OncologyCitation Excerpt :The pulmonary fibrosis score (PFS) was determined according to the modified criteria of Kazerroni et al.6 and was essentially based on the extent of the subpleural focal honeycombing. The pulmonary emphysema score was evaluated according to the criteria of Satoh et al.7 and was principally based on the extent of the low attenuation areas in the peripheral lung. The scoring definition and the typical CT findings of pulmonary fibrosis and pulmonary emphysema of each score are shown in Figure 1.
- 1
Presently at the Department of Radiology, KKR Takamatsu Hospital, Kagawa, Japan.