PULMONARY INVOLVEMENT IN PROGRESSIVE SYSTEMIC-SCLEROSIS - SEQUENTIAL EVALUATION WITH CT, PULMONARY-FUNCTION TESTS, AND BRONCHOALVEOLAR LAVAGE

Computed tomographic (CT) findings obtained in 53 patients with progre ssive systemic sclerosis were correlated with functional parameters an d bronchoalveolar lavage (BAL) results, and lung changes over time wer e assessed in 17 patients. CT findings were normal in 21 patients (gro up 1) with otherwise normal lung function, except for subclinical alve olitis in seven patients. CT depicted pleural and parenchymal abnormal ities in 32 patients, grouped according to the absence (group 2) or pr esence (group 3) of honeycombing. In group 2 (n = 13), mean values of functional parameters were normal, and BAL showed a significant increa se in neutrophils compared to group 1 (P < .05). Among patients in gro up 3 (n = 19) with limited extent of honeycombing (n = 12), the mean d iffusing capacity value was lower in patients with a moderate ground-g lass profusion score (n = 4) than in those with a mild score (n = 8) ( 68% +/- 4 [standard error of the mean] vs 80% +/- 3). CT is the method of choice for evaluating parenchymal destruction, and profusion and e xtent of ground-glass opacities can help in predicting the severity of lung damage in areas devoid of destructive changes.