[PMID]: | 28079597 |
[Au] Autor: | Trejo Bittar HE; Doberer D; Mehrad M; Strollo DC; Leader JK; Wenzel S; Yousem SA |
[Ad] Endereço: | Departments of *Pathology ‡Cardiothoracic Surgery, University of Pittsburgh Medical Center †Department of Medicine, Pulmonary Allergy and Critical Care Medicine Division, University of Pittsburgh Asthma Institute, University of Pittsburgh Medical Center, Pittsburgh, PA. |
[Ti] Título: | Histologic Findings of Severe/Therapy-Resistant Asthma From Video-assisted Thoracoscopic Surgery Biopsies. |
[So] Source: | Am J Surg Pathol;41(2):182-188, 2017 Feb. |
[Is] ISSN: | 1532-0979 |
[Cp] País de publicação: | United States |
[La] Idioma: | eng |
[Ab] Resumo: | The histologic changes occurring in severe/therapy-resistant asthma (SA) as defined by the European Respiratory Society/American Thoracic Society guidelines, particularly at the level of the distal airways are unknown. This study describes the clinical, radiologic, and histologic characteristics of 29 SA patients who underwent video-assisted thoracoscopic surgery lung biopsy. Pathologic observations were correlated with clinical features, especially the presence of autoimmune disease (AID) (15/29, 51.7%). Ten biopsies (10/29, 34.5%) showed only small airway manifestations of asthma, whereas in 19 (65.5%) asthmatic granulomatosis, manifested by asthmatic bronchiolitis supplemented by an alveolar septal mononuclear infiltrates with non-necrotizing granulomas, was present. SA patients without asthmatic granulomatosis showed more striking small airway injury, subbasement membrane thickening, and neutrophilic infiltrates. Cases with concurrent AID had a tendency to more parenchymal eosinophilic inflammation, more bronchiolocentric granulomas, and a suggestion of increased responsivity to nonsteroidal immunosuppressive therapy. Histologic examination of video-assisted thoracoscopic surgery lung biopsies in SA demonstrates diverse pathologies including cases associated with granulomatous inflammation in addition to eosinophilic infiltrates. This spectrum of histologies may link to a high incidence of AID. |
[Mh] Termos MeSH primário: |
Asma/patologia Doenças Autoimunes/complicações Bronquíolos/patologia Granuloma/patologia
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[Mh] Termos MeSH secundário: |
Adulto Asma/complicações Doenças Autoimunes/epidemiologia Biópsia Resistência a Medicamentos Feminino Granuloma/epidemiologia Seres Humanos Masculino Meia-Idade Prevalência Cirurgia Torácica Vídeoassistida
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[Pt] Tipo de publicação: | JOURNAL ARTICLE |
[Em] Mês de entrada: | 1707 |
[Cu] Atualização por classe: | 170719 |
[Lr] Data última revisão:
| 170719 |
[Sb] Subgrupo de revista: | IM |
[Da] Data de entrada para processamento: | 170113 |
[St] Status: | MEDLINE |
[do] DOI: | 10.1097/PAS.0000000000000777 |
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