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Changes in HRCT findings in patients with respiratory bronchiolitis-associated interstitial lung disease after smoking cessation

¹ Third Dept of Internal Medicine, ⁵ Nursing Science, and ³ Radiology, Medical Faculty, University of Fukui, and ² Thoracic Surgery, National Hospital Organisation, Fukui Hospital, Turuga, Fukui, and ⁴ Pathology, National Hospital Organisation, Kinki-Chuo Chest Medical Center, Sakai, Osaka, Japan.

CORRESPONDENCE: M. Nakanishi, Third Dept of Internal Medicine, Medical Faculty, University of Fukui, 23 Shimoaizuki Matsuoka-cho, Fukui Prefecture, 910-1193, Japan. Fax: 81 776618111. E-mail: mnakanishi{at}nifty.ne.jp

Keywords: High-resolution computed tomography, interstitial lung disease, respiratory bronchiolitis, respiratory bronchiolitis-associated interstitial lung disease, smoking cessation

Received: February 1, 2006
Accepted November 15, 2006

High-resolution computed tomography (HRCT) findings in patients with respiratory bronchiolitis-associated interstitial lung disease (RB-ILD) are varied and nonspecific. There is no known report of changes in HRCT findings and respiratory function test results for RB-ILD patients following the cessation of smoking.

Five patients with RB-ILD, confirmed by surgical lung biopsy, were retrospectively studied. Each stopped cigarette smoking and did not receive corticosteroid therapy after diagnosis. The clinical symptoms, respiratory function test results and HRCT findings obtained at the final observation were compared with those from the time of diagnosis.

Ground-glass opacity and centrilobular nodules corresponding to pathological respiratory bronchiolitis, as well as intralobular fine linear-reticular opacity corresponding to fibrosis involving the subpleural alveolar septa, showed computed tomography–pathological correlations. Both clinical symptoms and the diffusing capacity of the lungs for carbon monoxide improved significantly following smoking cessation, as did ground-glass opacity and centrilobular nodules seen during the initial HRCT examination.

Centrilobular nodules and ground-glass opacity, which are the main features of high-resolution computed tomography of respiratory bronchiolitis-associated interstitial lung disease patients and represent pathological respiratory bronchiolitis, can be improved by smoking cessation. The diffusing capacity of the lung for carbon monoxide in respiratory function tests can be also improved.