Pulmonary Pathology in Connective Tissue Disease

 

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Abstract

A significant proportion of patients with autoimmune connective tissue disease (CTD) show lung involvement that results in clinical interstitial lung disease (ILD). Surgical lung biopsy is helpful for diagnosis of CTD-ILD in many cases. In this review, we discuss the histologic manifestations of different types of CTD-ILD, focusing on patterns of disease and their differential diagnoses. Acquired autoimmune connective tissue diseases will be covered in this review, while lung involvement in vasculitides, heritable connective tissue disorders, and drug-induced CTD-like conditions will not be discussed.

• References

• 1 Mayberry JP, Primack SL, Müller NL. Thoracic manifestations of systemic autoimmune diseases: radiographic and high-resolution CT findings. Radiographics 2000; 20 (6) 1623-1635
  CrossrefPubMedGoogle Scholar
• 2 Kim EA, Lee KS, Johkoh T , et al. Interstitial lung diseases associated with collagen vascular diseases: radiologic and histopathologic findings. Radiographics 2002; 22 (Spec No): S151-S165
  CrossrefPubMedGoogle Scholar
• 3 Cheema GS, Quismorio Jr FP. Interstitial lung disease in systemic lupus erythematosus. Curr Opin Pulm Med 2000; 6 (5) 424-429
  CrossrefPubMedGoogle Scholar
• 4 Ryerson CJ, Collard HR. Update on the diagnosis and classification of ILD. Curr Opin Pulm Med 2013; 19 (5) 453-459
  CrossrefPubMedGoogle Scholar
• 5 Fishbein MC. Diagnosis: to biopsy or not to biopsy: assessing the role of surgical lung biopsy in the diagnosis of idiopathic pulmonary fibrosis. Chest 2005; 128 (5) (Suppl. 01) 520S-525S
  CrossrefPubMedGoogle Scholar
• 6 Ryerson CJ, Urbania TH, Richeldi L , et al. Prevalence and prognosis of unclassifiable interstitial lung disease. Eur Respir J 2013; 42 (3) 750-757
  CrossrefPubMedGoogle Scholar
• 7 Kaarteenaho R. The current position of surgical lung biopsy in the diagnosis of idiopathic pulmonary fibrosis. Respir Res 2013; 14 (1) 43
  CrossrefPubMedGoogle Scholar
• 8 Myers JL, Katzenstein AL. Beyond a consensus classification for idiopathic interstitial pneumonias: progress and controversies. Histopathology 2009; 54 (1) 90-103
  CrossrefPubMedGoogle Scholar
• 9 Chapman JT, Mehta AC. Bronchoscopy in sarcoidosis: diagnostic and therapeutic interventions. Curr Opin Pulm Med 2003; 9 (5) 402-407
  CrossrefPubMedGoogle Scholar
• 10 Griff S, Ammenwerth W, Schönfeld N , et al. Morphometrical analysis of transbronchial cryobiopsies. Diagn Pathol 2011; 6: 53
  CrossrefPubMedGoogle Scholar
• 11 Flaherty KR, Travis WD, Colby TV , et al. Histopathologic variability in usual and nonspecific interstitial pneumonias. Am J Respir Crit Care Med 2001; 164 (9) 1722-1727
  CrossrefPubMedGoogle Scholar
• 12 Tomashefski Jr JF. Pulmonary pathology of acute respiratory distress syndrome. Clin Chest Med 2000; 21 (3) 435-466
  CrossrefPubMedGoogle Scholar
• 13 The Acute Respiratory Distress Syndrome Network. Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. N Engl J Med 2000; 342 (18) 1301-1308
  CrossrefPubMedGoogle Scholar
• 14 Hamilton PP, Onayemi A, Smyth JA , et al. Comparison of conventional and high-frequency ventilation: oxygenation and lung pathology. J Appl Physiol 1983; 55 (1 Pt 1) 131-138
  PubMedGoogle Scholar
• 15 Parambil JG, Myers JL, Ryu JH. Diffuse alveolar damage: uncommon manifestation of pulmonary involvement in patients with connective tissue diseases. Chest 2006; 130 (2) 553-558
  CrossrefPubMedGoogle Scholar
• 16 Zamora MR, Warner ML, Tuder R, Schwarz MI. Diffuse alveolar hemorrhage and systemic lupus erythematosus. Clinical presentation, histology, survival, and outcome. Medicine (Baltimore) 1997; 76 (3) 192-202
  CrossrefPubMedGoogle Scholar
• 17 Asherson RA, Ridley M, Fletcher CD, Hughes GR. Systemic lupus erythematosus, pulmonary hypertension and adult respiratory distress syndrome (ARDS). Clin Exp Rheumatol 1988; 6 (3) 301-304
  PubMedGoogle Scholar
• 18 Haupt HM, Moore GW, Hutchins GM. The lung in systemic lupus erythematosus. Analysis of the pathologic changes in 120 patients. Am J Med 1981; 71 (5) 791-798
  CrossrefPubMedGoogle Scholar
• 19 Nadorra RL, Landing BH. Pulmonary lesions in childhood onset systemic lupus erythematosus: analysis of 26 cases, and summary of literature. Pediatr Pathol 1987; 7 (1) 1-18
  CrossrefPubMedGoogle Scholar
• 20 Tazelaar HD, Viggiano RW, Pickersgill J, Colby TV. Interstitial lung disease in polymyositis and dermatomyositis. Clinical features and prognosis as correlated with histologic findings. Am Rev Respir Dis 1990; 141 (3) 727-733
  CrossrefPubMedGoogle Scholar
• 21 Douglas WW, Tazelaar HD, Hartman TE , et al. Polymyositis-dermatomyositis-associated interstitial lung disease. Am J Respir Crit Care Med 2001; 164 (7) 1182-1185
  CrossrefPubMedGoogle Scholar
• 22 Fujisawa T, Suda T, Nakamura Y , et al. Differences in clinical features and prognosis of interstitial lung diseases between polymyositis and dermatomyositis. J Rheumatol 2005; 32 (1) 58-64
  PubMedGoogle Scholar
• 23 Yousem SA, Colby TV, Carrington CB. Lung biopsy in rheumatoid arthritis. Am Rev Respir Dis 1985; 131 (5) 770-777
  PubMedGoogle Scholar
• 24 Muir TE, Tazelaar HD, Colby TV, Myers JL. Organizing diffuse alveolar damage associated with progressive systemic sclerosis. Mayo Clin Proc 1997; 72 (7) 639-642
  CrossrefPubMedGoogle Scholar
• 25 Phillips K, Byrne-Dugan C, Batterson E, Seibold JR. Rapidly progressive fatal interstitial lung disease in a patient with systemic sclerosis. Nat Rev Rheumatol 2009; 5 (4) 225-228
  CrossrefPubMedGoogle Scholar
• 26 Usui Y, Kimula Y, Miura H , et al. A case of bronchiolitis obliterans organizing pneumonia associated with primary Sjögren's syndrome who died of superimposed diffuse alveolar damage. Respiration 1992; 59 (2) 122-124
  CrossrefPubMedGoogle Scholar
• 27 Watanabe Y, Koyama S, Moriguchi M , et al. Rapidly progressive respiratory failure in mixed connective tissue disease: report of an autopsy case. Intern Med 2012; 51 (24) 3415-3419
  CrossrefPubMedGoogle Scholar
• 28 Leslie KO. My approach to interstitial lung disease using clinical, radiological and histopathological patterns. J Clin Pathol 2009; 62 (5) 387-401
  CrossrefPubMedGoogle Scholar
• 29 Churg A, Wright JL, Tazelaar HD. Acute exacerbations of fibrotic interstitial lung disease. Histopathology 2011; 58 (4) 525-530
  CrossrefPubMedGoogle Scholar
• 30 Beasley MB, Franks TJ, Galvin JR, Gochuico B, Travis WD. Acute fibrinous and organizing pneumonia: a histological pattern of lung injury and possible variant of diffuse alveolar damage. Arch Pathol Lab Med 2002; 126 (9) 1064-1070
  PubMedGoogle Scholar
• 31 Hariri LP, Unizony S, Stone J , et al. Acute fibrinous and organizing pneumonia in systemic lupus erythematosus: a case report and review of the literature. Pathol Int 2010; 60 (11) 755-759
  CrossrefPubMedGoogle Scholar
• 32 Valim V, Rocha RH, Couto RB, Paixão TS, Serrano EV. Acute fibrinous and organizing pneumonia and undifferentiated connective tissue disease: a case report. Case Rep Rheumatol 2012; 2012: 549298
  PubMedGoogle Scholar
• 33 Ward MM, Donald F. Pneumocystis carinii pneumonia in patients with connective tissue diseases: the role of hospital experience in diagnosis and mortality. Arthritis Rheum 1999; 42 (4) 780-789
  CrossrefPubMedGoogle Scholar
• 34 Kennedy JI, Myers JL, Plumb VJ, Fulmer JD. Amiodarone pulmonary toxicity. Clinical, radiologic, and pathologic correlations. Arch Intern Med 1987; 147 (1) 50-55
  CrossrefPubMedGoogle Scholar
• 35 Larsen BT, Vaszar LT, Colby TV, Tazelaar HD. Lymphoid hyperplasia and eosinophilic pneumonia as histologic manifestations of amiodarone-induced lung toxicity. Am J Surg Pathol 2012; 36 (4) 509-516
  CrossrefPubMedGoogle Scholar
• 36 Bedrossian CW, Warren CJ, Ohar J, Bhan R. Amiodarone pulmonary toxicity: cytopathology, ultrastructure, and immunocytochemistry. Ann Diagn Pathol 1997; 1 (1) 47-56
  CrossrefPubMedGoogle Scholar
• 37 Lee HK, Kim DS, Yoo B , et al. Histopathologic pattern and clinical features of rheumatoid arthritis-associated interstitial lung disease. Chest 2005; 127 (6) 2019-2027
  CrossrefPubMedGoogle Scholar
• 38 Henriet AC, Diot E, Marchand-Adam S , et al. Organising pneumonia can be the inaugural manifestation in connective tissue diseases, including Sjogren's syndrome. Eur Respir Rev 2010; 19 (116) 161-163
  CrossrefPubMedGoogle Scholar
• 39 Tansey D, Wells AU, Colby TV , et al. Variations in histological patterns of interstitial pneumonia between connective tissue disorders and their relationship to prognosis. Histopathology 2004; 44 (6) 585-596
  CrossrefPubMedGoogle Scholar
• 40 Gammon RB, Bridges TA, al-Nezir H, Alexander CB, Kennedy Jr JI. Bronchiolitis obliterans organizing pneumonia associated with systemic lupus erythematosus. Chest 1992; 102 (4) 1171-1174
  CrossrefPubMedGoogle Scholar
• 41 Otsuka F, Amano T, Hashimoto N , et al. Bronchiolitis obliterans organizing pneumonia associated with systemic lupus erythematosus with antiphospholipid antibody. Intern Med 1996; 35 (4) 341-344
  CrossrefPubMedGoogle Scholar
• 42 Bouros D, Wells AU, Nicholson AG , et al. Histopathologic subsets of fibrosing alveolitis in patients with systemic sclerosis and their relationship to outcome. Am J Respir Crit Care Med 2002; 165 (12) 1581-1586
  CrossrefPubMedGoogle Scholar
• 43 Parambil JG, Myers JL, Lindell RM, Matteson EL, Ryu JH. Interstitial lung disease in primary Sjögren syndrome. Chest 2006; 130 (5) 1489-1495
  CrossrefPubMedGoogle Scholar
• 44 Ito I, Nagai S, Kitaichi M , et al. Pulmonary manifestations of primary Sjogren's syndrome: a clinical, radiologic, and pathologic study. Am J Respir Crit Care Med 2005; 171 (6) 632-638
  CrossrefPubMedGoogle Scholar
• 45 Katzenstein AL, Fiorelli RF. Nonspecific interstitial pneumonia/fibrosis. Histologic features and clinical significance. Am J Surg Pathol 1994; 18 (2) 136-147
  CrossrefPubMedGoogle Scholar
• 46 Kim DS, Yoo B, Lee JS , et al. The major histopathologic pattern of pulmonary fibrosis in scleroderma is nonspecific interstitial pneumonia. Sarcoidosis Vasc Diffuse Lung Dis 2002; 19 (2) 121-127
  PubMedGoogle Scholar
• 47 Eisenberg H, Dubois EL, Sherwin RP, Balchum OJ. Diffuse interstitial lung disease in systemic lupus erythematosus. Ann Intern Med 1973; 79 (1) 37-45
  CrossrefPubMedGoogle Scholar
• 48 Nicholson AG. Lymphocytic interstitial pneumonia and other lymphoproliferative disorders in the lung. Semin Respir Crit Care Med 2001; 22 (4) 409-422
  Article in Thieme ConnectPubMedGoogle Scholar
• 49 Morris JC, Rosen MJ, Marchevsky A, Teirstein AS. Lymphocytic interstitial pneumonia in patients at risk for the acquired immune deficiency syndrome. Chest 1987; 91 (1) 63-67
  CrossrefPubMedGoogle Scholar
• 50 Oldham SA, Castillo M, Jacobson FL, Mones JM, Saldana MJ. HIV-associated lymphocytic interstitial pneumonia: radiologic manifestations and pathologic correlation. Radiology 1989; 170 (1 Pt 1) 83-87
  CrossrefPubMedGoogle Scholar
• 51 Deheinzelin D, Capelozzi VL, Kairalla RA, Barbas Filho JV, Saldiva PH, de Carvalho CR. Interstitial lung disease in primary Sjögren's syndrome. Clinical-pathological evaluation and response to treatment. Am J Respir Crit Care Med 1996; 154 (3 Pt 1) 794-799
  CrossrefPubMedGoogle Scholar
• 52 Cha SI, Fessler MB, Cool CD, Schwarz MI, Brown KK. Lymphoid interstitial pneumonia: clinical features, associations and prognosis. Eur Respir J 2006; 28 (2) 364-369
  CrossrefPubMedGoogle Scholar
• 53 Fortoul TI, Cano-Valle F, Oliva E, Barrios R. Follicular bronchiolitis in association with connective tissue diseases. Lung 1985; 163 (5) 305-314
  CrossrefPubMedGoogle Scholar
• 54 Epler GR, Snider GL, Gaensler EA, Cathcart ES, FitzGerald MX, Carrington CB. Bronchiolitis and bronchitis in connective tissue disease. A possible relationship to the use of penicillamine. JAMA 1979; 242 (6) 528-532
  CrossrefPubMedGoogle Scholar
• 55 Colby TV. Pulmonary pathology in patients with systemic autoimmune diseases. Clin Chest Med 1998; 19 (4) 587-612 , vii
  CrossrefPubMedGoogle Scholar
• 56 Allen TC. Pathology of small airways disease. Arch Pathol Lab Med 2010; 134 (5) 702-718
  PubMedGoogle Scholar
• 57 Wright JL, Cagle P, Churg A, Colby TV, Myers J. Diseases of the small airways. Am Rev Respir Dis 1992; 146 (1) 240-262
  CrossrefPubMedGoogle Scholar
• 58 Colby TV. Bronchiolitis. Pathologic considerations. Am J Clin Pathol 1998; 109 (1) 101-109
  CrossrefPubMedGoogle Scholar
• 59 Nakanishi M, Fukuoka J, Tanaka T , et al. Small airway disease associated with Sjögren's syndrome: clinico-pathological correlations. Respir Med 2011; 105 (12) 1931-1938
  CrossrefPubMedGoogle Scholar
• 60 Howling SJ, Hansell DM, Wells AU, Nicholson AG, Flint JD, Müller NL. Follicular bronchiolitis: thin-section CT and histologic findings. Radiology 1999; 212 (3) 637-642
  CrossrefPubMedGoogle Scholar
• 61 Keane MP, Lynch III JP. Pleuropulmonary manifestations of systemic lupus erythematosus. Thorax 2000; 55 (2) 159-166
  CrossrefPubMedGoogle Scholar
• 62 Travis WD, Costabel U, Hansell DM , et al; ATS/ERS Committee on Idiopathic Interstitial Pneumonias. An official American Thoracic Society/European Respiratory Society statement: Update of the international multidisciplinary classification of the idiopathic interstitial pneumonias. Am J Respir Crit Care Med 2013; 188 (6) 733-748
  CrossrefPubMedGoogle Scholar
• 63 Reichenspurner H, Girgis RE, Robbins RC , et al. Obliterative bronchiolitis after lung and heart-lung transplantation. Ann Thorac Surg 1995; 60 (6) 1845-1853
  CrossrefPubMedGoogle Scholar
• 64 Schlesinger C, Meyer CA, Veeraraghavan S, Koss MN. Constrictive (obliterative) bronchiolitis: diagnosis, etiology, and a critical review of the literature. Ann Diagn Pathol 1998; 2 (5) 321-334
  CrossrefPubMedGoogle Scholar
• 65 Lynch III JP, Weigt SS, DerHovanessian A, Fishbein MC, Gutierrez A, Belperio JA. Obliterative (constrictive) bronchiolitis. Semin Respir Crit Care Med 2012; 33 (5) 509-532
  Article in Thieme ConnectPubMedGoogle Scholar
• 66 Myers JL, Colby TV. Pathologic manifestations of bronchiolitis, constrictive bronchiolitis, cryptogenic organizing pneumonia, and diffuse panbronchiolitis. Clin Chest Med 1993; 14 (4) 611-622
  PubMedGoogle Scholar
• 67 Geddes DM, Corrin B, Brewerton DA, Davies RJ, Turner-Warwick M. Progressive airway obliteration in adults and its association with rheumatoid disease. Q J Med 1977; 46 (184) 427-444
  PubMedGoogle Scholar
• 68 Bégin R, Massé S, Cantin A, Ménard HA, Bureau MA. Airway disease in a subset of nonsmoking rheumatoid patients. Characterization of the disease and evidence for an autoimmune pathogenesis. Am J Med 1982; 72 (5) 743-750
  CrossrefPubMedGoogle Scholar
• 69 Devouassoux G, Cottin V, Lioté H , et al; Groupe d'Etudes et de Recherche sur les Maladies “Orphelines” Pulmonaires (GERM”O”P). Characterisation of severe obliterative bronchiolitis in rheumatoid arthritis. Eur Respir J 2009; 33 (5) 1053-1061
  CrossrefPubMedGoogle Scholar
• 70 Tzeng DZ, Leslie KO, Shelton D, Chan A. Unusual dyspnea in a woman with CREST syndrome. Chest 2008; 133 (1) 286-290
  CrossrefPubMedGoogle Scholar
• 71 Fagan KA, Badesch DB. Pulmonary hypertension associated with connective tissue disease. Prog Cardiovasc Dis 2002; 45 (3) 225-234
  CrossrefPubMedGoogle Scholar
• 72 Galiè N, Manes A, Farahani KV , et al. Pulmonary arterial hypertension associated to connective tissue diseases. Lupus 2005; 14 (9) 713-717
  CrossrefPubMedGoogle Scholar
• 73 Shahane A. Pulmonary hypertension in rheumatic diseases: epidemiology and pathogenesis. Rheumatol Int 2013; 33 (7) 1655-1667
  CrossrefPubMedGoogle Scholar
• 74 Wagenvoort CA. The pathology of primary pulmonary hypertension. J Pathol 1970; 101 (4)
  PubMedGoogle Scholar
• 75 Young RH, Mark GJ. Pulmonary vascular changes in scleroderma. Am J Med 1978; 64 (6) 998-1004
  CrossrefPubMedGoogle Scholar
• 76 Pietra GG, Edwards WD, Kay JM , et al. Histopathology of primary pulmonary hypertension. A qualitative and quantitative study of pulmonary blood vessels from 58 patients in the National Heart, Lung, and Blood Institute, Primary Pulmonary Hypertension Registry. Circulation 1989; 80 (5) 1198-1206
  CrossrefPubMedGoogle Scholar
• 77 Dorfmüller P, Humbert M, Perros F , et al. Fibrous remodeling of the pulmonary venous system in pulmonary arterial hypertension associated with connective tissue diseases. Hum Pathol 2007; 38 (6) 893-902
  CrossrefPubMedGoogle Scholar
• 78 Koh ET, Lee P, Gladman DD, Abu-Shakra M. Pulmonary hypertension in systemic sclerosis: an analysis of 17 patients. Br J Rheumatol 1996; 35 (10) 989-993
  CrossrefPubMedGoogle Scholar
• 79 Salerni R, Rodnan GP, Leon DF, Shaver JA. Pulmonary hypertension in the CREST syndrome variant of progressive systemic sclerosis (scleroderma). Ann Intern Med 1977; 86 (4) 394-399
  CrossrefPubMedGoogle Scholar
• 80 Cool CD, Kennedy D, Voelkel NF, Tuder RM. Pathogenesis and evolution of plexiform lesions in pulmonary hypertension associated with scleroderma and human immunodeficiency virus infection. Hum Pathol 1997; 28 (4) 434-442
  CrossrefPubMedGoogle Scholar
• 81 Yousem SA. The pulmonary pathologic manifestations of the CREST syndrome. Hum Pathol 1990; 21 (5) 467-474
  CrossrefPubMedGoogle Scholar
• 82 Fayemi AO. Pulmonary vascular disease in systemic lupus erythematosus. Am J Clin Pathol 1976; 65 (3) 284-290
  PubMedGoogle Scholar
• 83 Quismorio Jr FP, Sharma O, Koss M , et al. Immunopathologic and clinical studies in pulmonary hypertension associated with systemic lupus erythematosus. Semin Arthritis Rheum 1984; 13 (4) 349-359
  CrossrefPubMedGoogle Scholar
• 84 Gardner DL, Duthie JJ, MacLeod J, Allan WS. Pulmonary hypertension in rheumatoid arthritis: report of a case with intimal sclerosis of the pulmonary and digital arteries. Scott Med J 1957; 2 (5) 183-188
  PubMedGoogle Scholar
• 85 Onodera S, Hill JR. Pulmonary Hypertension. Report of a Case in Association with Rheumatoid Arthritis. Ohio State Med J 1965; 61: 141-144
  PubMedGoogle Scholar
• 86 Castro GW, Appenzeller S, Bertolo MB, Costallat LT. Isolated pulmonary hypertension secondary to rheumatoid arthritis. Clin Rheumatol 2006; 25 (6) 901-903
  CrossrefPubMedGoogle Scholar
• 87 Caldwell IW, Aitchison JD. Pulmonary hypertension in dermatomyositis. Br Heart J 1956; 18 (2) 273-276
  CrossrefPubMedGoogle Scholar
• 88 Bunch TW, Tancredi RG, Lie JT. Pulmonary hypertension in polymyositis. Chest 1981; 79 (1) 105-107
  CrossrefPubMedGoogle Scholar
• 89 Grateau G, Roux ME, Franck N , et al. Pulmonary hypertension in a case of dermatomyositis. J Rheumatol 1993; 20 (8) 1452-1453
  PubMedGoogle Scholar
• 90 Minai OA. Pulmonary hypertension in polymyositis-dermatomyositis: clinical and hemodynamic characteristics and response to vasoactive therapy. Lupus 2009; 18 (11) 1006-1010
  CrossrefPubMedGoogle Scholar
• 91 Sullivan WD, Hurst DJ, Harmon CE , et al. A prospective evaluation emphasizing pulmonary involvement in patients with mixed connective tissue disease. Medicine (Baltimore) 1984; 63 (2) 92-107
  CrossrefPubMedGoogle Scholar
• 92 Bull TM, Fagan KA, Badesch DB. Pulmonary vascular manifestations of mixed connective tissue disease. Rheum Dis Clin North Am 2005; 31 (3) 451-464 , vi
  CrossrefPubMedGoogle Scholar
• 93 Alpert MA, Goldberg SH, Singsen BH , et al. Cardiovascular manifestations of mixed connective tissue disease in adults. Circulation 1983; 68 (6) 1182-1193
  CrossrefPubMedGoogle Scholar
• 94 Launay D, Hachulla E, Hatron PY, Jais X, Simonneau G, Humbert M. Pulmonary arterial hypertension: a rare complication of primary Sjögren syndrome: report of 9 new cases and review of the literature. Medicine (Baltimore) 2007; 86 (5) 299-315
  CrossrefPubMedGoogle Scholar
• 95 Wagenvoort CA, Wagenvoort N. The pathology of pulmonary veno-occlusive disease. Virchows Arch A Pathol Anat Histol 1974; 364 (1) 69-79
  CrossrefPubMedGoogle Scholar
• 96 Lantuéjoul S, Sheppard MN, Corrin B, Burke MM, Nicholson AG. Pulmonary veno-occlusive disease and pulmonary capillary hemangiomatosis: a clinicopathologic study of 35 cases. Am J Surg Pathol 2006; 30 (7) 850-857
  CrossrefPubMedGoogle Scholar
• 97 Urisman A, Leard LE, Nathan M , et al. Rapidly progressive pulmonary venoocclusive disease in young women taking oral contraceptives. J Heart Lung Transplant 2012; 31 (9) 1031-1036
  CrossrefPubMedGoogle Scholar
• 98 Travis WD, Colby TV, Lombard C, Carpenter HA. A clinicopathologic study of 34 cases of diffuse pulmonary hemorrhage with lung biopsy confirmation. Am J Surg Pathol 1990; 14 (12) 1112-1125
  CrossrefPubMedGoogle Scholar
• 99 Colby TV, Fukuoka J, Ewaskow SP, Helmers R, Leslie KO. Pathologic approach to pulmonary hemorrhage. Ann Diagn Pathol 2001; 5 (5) 309-319
  CrossrefPubMedGoogle Scholar
• 100 Mark EJ, Ramirez JF. Pulmonary capillaritis and hemorrhage in patients with systemic vasculitis. Arch Pathol Lab Med 1985; 109 (5) 413-418
  PubMedGoogle Scholar
• 101 Belmont HM, Abramson SB, Lie JT. Pathology and pathogenesis of vascular injury in systemic lupus erythematosus. Interactions of inflammatory cells and activated endothelium. Arthritis Rheum 1996; 39 (1) 9-22
  CrossrefPubMedGoogle Scholar
• 102 Franks TJ, Koss MN. Pulmonary capillaritis. Curr Opin Pulm Med 2000; 6 (5) 430-435
  CrossrefPubMedGoogle Scholar
• 103 Yi ES, Colby TV. Wegener's granulomatosis. Semin Diagn Pathol 2001; 18 (1) 34-46
  PubMedGoogle Scholar
• 104 Marino CT, Pertschuk LP. Pulmonary hemorrhage in systemic lupus erythematosus. Arch Intern Med 1981; 141 (2) 201-203
  CrossrefPubMedGoogle Scholar
• 105 Myers JL, Katzenstein AA. Microangiitis in lupus-induced pulmonary hemorrhage. Am J Clin Pathol 1986; 85 (5) 552-556
  PubMedGoogle Scholar
• 106 Churg A, Franklin W, Chan KL, Kopp E, Carrington CB. Pulmonary hemorrhage and immune-complex deposition in the lung. Complications in a patient with systemic lupus erythematosus. Arch Pathol Lab Med 1980; 104 (7) 388-391
  PubMedGoogle Scholar
• 107 Schwarz MI, Zamora MR, Hodges TN, Chan ED, Bowler RP, Tuder RM. Isolated pulmonary capillaritis and diffuse alveolar hemorrhage in rheumatoid arthritis and mixed connective tissue disease. Chest 1998; 113 (6) 1609-1615
  CrossrefPubMedGoogle Scholar
• 108 Griffin MT, Robb JD, Martin JR. Diffuse alveolar haemorrhage associated with progressive systemic sclerosis. Thorax 1990; 45 (11) 903-904
  CrossrefPubMedGoogle Scholar
• 109 Vázquez-Del Mercado M, Mendoza-Topete A, Best-Aguilera CR, Garcia-De La Torre I. Diffuse alveolar hemorrhage in limited cutaneous systemic sclerosis with positive perinuclear antineutrophil cytoplasmic antibodies. J Rheumatol 1996; 23 (10) 1821-1823
  PubMedGoogle Scholar
• 110 Kallenbach J, Prinsloo I, Zwi S. Progressive systemic sclerosis complicated by diffuse pulmonary haemorrhage. Thorax 1977; 32 (6) 767-770
  CrossrefPubMedGoogle Scholar
• 111 Chaer RA, Massad MG, Evans A, Olopade C, Varga J. Systemic sclerosis complicated by diffuse alveolar hemorrhage. Med Sci Monit 2001; 7 (5) 1013-1015
  PubMedGoogle Scholar
• 112 Schwarz MI, Sutarik JM, Nick JA, Leff JA, Emlen JW, Tuder RM. Pulmonary capillaritis and diffuse alveolar hemorrhage. A primary manifestation of polymyositis. Am J Respir Crit Care Med 1995; 151 (6) 2037-2040
  CrossrefPubMedGoogle Scholar
• 113 Joseph J, Sahn SA. Connective tissue diseases and the pleura. Chest 1993; 104 (1) 262-270
  CrossrefPubMedGoogle Scholar
• 114 Bouros D, Pneumatikos I, Tzouvelekis A. Pleural involvement in systemic autoimmune disorders. Respiration 2008; 75 (4) 361-371
  CrossrefPubMedGoogle Scholar
• 115 Walker WC, Wright V. Pulmonary lesions and rheumatoid arthritis. Medicine (Baltimore) 1968; 47 (6) 501-520
  CrossrefPubMedGoogle Scholar
• 116 Baum J. Infection in rheumatoid arthritis. Arthritis Rheum 1971; 14 (1) 135-137
  CrossrefPubMedGoogle Scholar
• 117 Ziff M. The rheumatoid nodule. Arthritis Rheum 1990; 33 (6) 761-767
  CrossrefPubMedGoogle Scholar
• 118 Katzenstein AL, Mukhopadhyay S, Myers JL. Diagnosis of usual interstitial pneumonia and distinction from other fibrosing interstitial lung diseases. Hum Pathol 2008; 39 (9) 1275-1294
  CrossrefPubMedGoogle Scholar
• 119 Smith M, Dalurzo M, Panse P, Parish J, Leslie K. Usual interstitial pneumonia-pattern fibrosis in surgical lung biopsies. Clinical, radiological and histopathological clues to aetiology. J Clin Pathol 2013; 66 (10) 896-903
  CrossrefPubMedGoogle Scholar
• 120 Flaherty KR, Colby TV, Travis WD , et al. Fibroblastic foci in usual interstitial pneumonia: idiopathic versus collagen vascular disease. Am J Respir Crit Care Med 2003; 167 (10) 1410-1415
  CrossrefPubMedGoogle Scholar
• 121 Song JW, Do KH, Kim MY, Jang SJ, Colby TV, Kim DS. Pathologic and radiologic differences between idiopathic and collagen vascular disease-related usual interstitial pneumonia. Chest 2009; 136 (1) 23-30
  CrossrefPubMedGoogle Scholar
• 122 Churg A, Sin DD, Everett D, Brown K, Cool C. Pathologic patterns and survival in chronic hypersensitivity pneumonitis. Am J Surg Pathol 2009; 33 (12) 1765-1770
  CrossrefPubMedGoogle Scholar
• 123 Akashi T, Takemura T, Ando N , et al. Histopathologic analysis of sixteen autopsy cases of chronic hypersensitivity pneumonitis and comparison with idiopathic pulmonary fibrosis/usual interstitial pneumonia. Am J Clin Pathol 2009; 131 (3) 405-415
  CrossrefPubMedGoogle Scholar
• 124 Hayakawa H, Shirai M, Sato A , et al. Clinicopathological features of chronic hypersensitivity pneumonitis. Respirology 2002; 7 (4) 359-364
  CrossrefPubMedGoogle Scholar
• 125 Rosenow III EC, DeRemee RA, Dines DE. Chronic nitrofurantoin pulmonary reaction. Report of 5 cases. N Engl J Med 1968; 279 (23) 1258-1262
  CrossrefPubMedGoogle Scholar
• 126 Leslie KO, Cool CD, Sporn TA , et al. Familial idiopathic interstitial pneumonia: histopathology and survival in 30 patients. Arch Pathol Lab Med 2012; 136 (11) 1366-1376
  CrossrefPubMedGoogle Scholar
• 127 Anderson LG, Talal N. The spectrum of benign to malignant lymphoproliferation in Sjögren's syndrome. Clin Exp Immunol 1972; 10 (2) 199-221
  PubMedGoogle Scholar
• 128 Butnor K, Khoor A. Collagen vascular diseases and disorders of connective tissue. In: Tomashefski JF, , ed. Dail and Hammar's Pulmonary Pathology. 3rd ed. New York, NY: Springer; 2008
  CrossrefGoogle Scholar
• 129 Shakespeare W, Brooke T. The Third Part of King Henry the Sixth. New Haven, CT: Yale University Press; 1923
  CrossrefGoogle Scholar