Santiago Martinez-Jimenez MD, Presenter: Author, Amirsys, Inc

Melissa L. Rosado De Christenson MD, Abstract Co-Author: Author, Thieme Medical Publishers, Inc Author, Amirsys, Inc Author, American Registry of Pathology Author, Oxford University Press

Christopher Walker MD, Abstract Co-Author: Author, Amirsys, Inc Author, Reed Elsevier

Jeffrey Russell Kunin MD, Abstract Co-Author: Investigator, Oncimmune LLC

Paul P. Pettavel MD, Abstract Co-Author: Nothing to Disclose

1. The traditional classification of hypersensitivity pneumonitis (HP) includes acute, subacute and chronic types. Subacute HP is characterized by diffuse centrilobular ground-glass nodules. Chronic HP typically manifests as upper lobe predominant architectural distortion and fibrosis and may exhibit ground-glass opacity and air-trapping. 2. A proposed new classification divides HP into two disease clusters. Cluster 1 HP is characterized by respiratory symptoms (e.g. chest tightness), occurrence hours after exposure, systemic symptoms (e.g. chills, body aches), and imaging features of acute and subacute HP. Cluster 2 HP is characterized by symptoms similar to those of chronic interstitial lung disease (i.e. clubbing, hypoxemia, inspiratory crackles), abnormal pulmonary function tests, and imaging features of chronic HP.

1. Describe traditional classification and imaging features of HP. 2. Discuss limitations of the traditional classification including poor epidemiologic and pathologic validation and poor evidence of disease progression along the acute, subacute, and chronic spectrum. 3. Outline proposed new classification based on demographic, clinical and HRCT features which divides disease into Cluster 1 and Cluster 2. 4. Present typical imaging findings of HP in both clusters with supporting histopathology.

http://abstract.rsna.org/uploads/2014/14009799/14009799_ykid.pdf

Martinez-Jimenez, S, Rosado De Christenson, M, Walker, C, Kunin, J, Pettavel, P, Current Concepts in Hypersensitivity Pneumonitis.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14009799.html