Interstitial lung disease in association with polymyositis-dermatomyositis: Long-term follow-up CT evaluation in seven patients

PURPOSE: To determine the long-term follow-up computed tomographic (CT) fin dings of interstitial lung disease associated with polymyositis-dermatomyos itis.; MATERIALS AND METHODS: CT scans in seven patients with interstitial lung di sease and associated polymyositis-dermatomyositis were evaluated retrospect ively. Six patients underwent sequential CT (follow-up range, 2-8 years; me an, 4.3 years). Histologic confirmation of pulmonary involvement was availa ble in five patients. RESULTS: The predominant finding on the initial CT scans in four patients w as subpleural consolidation, which corresponded to bronchiolitis obliterans organizing pneumonia with or without coexistent chronic eosinophilic pneum onia. In most cases, consolidation improved with use of corticosteroid and/ or immunosuppressive therapy; in two patients, however, consolidation evolv ed into honeycombing. In one patient, diffuse areas of ground-glass opacity and consolidation appeared rapidly : during illness; this patient died of sudden, rapid deterioration. In one patient with subpleural linear opacitie s, parenchymal abnormalities slowly progressed, and linear opacities had ev olved into honeycombing at 8-year follow-up. In one patient with histologic ally proved organizing diffuse alveolar damage, bilateral patchy areas of g round-glass opacity and consolidation were seen. In one patient, subpleural bands changed to subpleural lines on sequential CT scans. CONCLUSION: CT provides an excellent demonstration of the lung changes in p atients with interstitial lung disease and associated polymyositis-dermatom yositis.