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The Octopus Sign—A New HRCT Sign in Pulmonary Langerhans Cell Histiocytosis

Background: Fibrosis in pulmonary Langerhans cell histiocytosis (PLCH) histologically comprises a central scar with septal strands and associated airspace enlargement that produce an octopus-like appearance. The purpose of this study was to identify the octopus sign on high-resolution computed tomog...

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Autores principales: Poellinger, Alexander, Berezowska, Sabina, Myers, Jeffrey Leon, Huber, Adrian, Funke-Chambour, Manuela, Guler, Sabina, Geiser, Thomas, Harari, Sergio, Caminati, Antonella, Zompatori, Maurizio, Sverzellati, Nicola
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9025181/
https://www.ncbi.nlm.nih.gov/pubmed/35453983
http://dx.doi.org/10.3390/diagnostics12040937
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author Poellinger, Alexander
Berezowska, Sabina
Myers, Jeffrey Leon
Huber, Adrian
Funke-Chambour, Manuela
Guler, Sabina
Geiser, Thomas
Harari, Sergio
Caminati, Antonella
Zompatori, Maurizio
Sverzellati, Nicola
author_facet Poellinger, Alexander
Berezowska, Sabina
Myers, Jeffrey Leon
Huber, Adrian
Funke-Chambour, Manuela
Guler, Sabina
Geiser, Thomas
Harari, Sergio
Caminati, Antonella
Zompatori, Maurizio
Sverzellati, Nicola
author_sort Poellinger, Alexander
collection PubMed
description Background: Fibrosis in pulmonary Langerhans cell histiocytosis (PLCH) histologically comprises a central scar with septal strands and associated airspace enlargement that produce an octopus-like appearance. The purpose of this study was to identify the octopus sign on high-resolution computed tomography (HRCT) images to determine its frequency and distribution across stages of the disease. Methods: Fifty-seven patients with confirmed PLCH were included. Two experienced chest radiologists assessed disease stages as early, intermediate, or late, as well as the lung parenchyma for nodular, cystic, or fibrotic changes and for the presence of the octopus sign. Statistical analysis included Cohen’s kappa for interrater agreement and Fisher’s exact test for the frequency of the octopus sign. Results: Interobserver agreement was substantial for the octopus sign (kappa = 0.747). Significant differences in distribution of the octopus sign between stages 2 and 3 were found with more frequent octopus signs in stage 2 and fewer in stage 3. In addition, we only found the octopus sign in cases of nodular und cystic lung disease. Conclusions: The octopus sign in PLCH can be identified not only on histological images, but also on HRCT images. Its radiological presence seems to depend on the stage of PLCH.
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spelling pubmed-90251812022-04-23 The Octopus Sign—A New HRCT Sign in Pulmonary Langerhans Cell Histiocytosis Poellinger, Alexander Berezowska, Sabina Myers, Jeffrey Leon Huber, Adrian Funke-Chambour, Manuela Guler, Sabina Geiser, Thomas Harari, Sergio Caminati, Antonella Zompatori, Maurizio Sverzellati, Nicola Diagnostics (Basel) Article Background: Fibrosis in pulmonary Langerhans cell histiocytosis (PLCH) histologically comprises a central scar with septal strands and associated airspace enlargement that produce an octopus-like appearance. The purpose of this study was to identify the octopus sign on high-resolution computed tomography (HRCT) images to determine its frequency and distribution across stages of the disease. Methods: Fifty-seven patients with confirmed PLCH were included. Two experienced chest radiologists assessed disease stages as early, intermediate, or late, as well as the lung parenchyma for nodular, cystic, or fibrotic changes and for the presence of the octopus sign. Statistical analysis included Cohen’s kappa for interrater agreement and Fisher’s exact test for the frequency of the octopus sign. Results: Interobserver agreement was substantial for the octopus sign (kappa = 0.747). Significant differences in distribution of the octopus sign between stages 2 and 3 were found with more frequent octopus signs in stage 2 and fewer in stage 3. In addition, we only found the octopus sign in cases of nodular und cystic lung disease. Conclusions: The octopus sign in PLCH can be identified not only on histological images, but also on HRCT images. Its radiological presence seems to depend on the stage of PLCH. MDPI 2022-04-08 /pmc/articles/PMC9025181/ /pubmed/35453983 http://dx.doi.org/10.3390/diagnostics12040937 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Poellinger, Alexander
Berezowska, Sabina
Myers, Jeffrey Leon
Huber, Adrian
Funke-Chambour, Manuela
Guler, Sabina
Geiser, Thomas
Harari, Sergio
Caminati, Antonella
Zompatori, Maurizio
Sverzellati, Nicola
The Octopus Sign—A New HRCT Sign in Pulmonary Langerhans Cell Histiocytosis
title The Octopus Sign—A New HRCT Sign in Pulmonary Langerhans Cell Histiocytosis
title_full The Octopus Sign—A New HRCT Sign in Pulmonary Langerhans Cell Histiocytosis
title_fullStr The Octopus Sign—A New HRCT Sign in Pulmonary Langerhans Cell Histiocytosis
title_full_unstemmed The Octopus Sign—A New HRCT Sign in Pulmonary Langerhans Cell Histiocytosis
title_short The Octopus Sign—A New HRCT Sign in Pulmonary Langerhans Cell Histiocytosis
title_sort octopus sign—a new hrct sign in pulmonary langerhans cell histiocytosis
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9025181/
https://www.ncbi.nlm.nih.gov/pubmed/35453983
http://dx.doi.org/10.3390/diagnostics12040937
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