BACKGROUND Interstitial lung disease (ILD) is the most common and important pulmonary manifestation of rheumatoid arthritis (RA). A radiological honeycomb pattern has been described in diverse forms of ILD that can impact survival. However, the clinical course and sequential radiological changes in the formation of the honeycomb pattern in patients with RA-ILD is not fully understood. METHODS We evaluated the sequential changes in computed tomography findings in 40 patients with chronic forms of RA-ILD without the honeycomb pattern at initial diagnosis. We classified the patients into the Non-honeycomb group and Honeycomb group, and then analyzed the characteristics and prognosis of the two groups. The term "honeycomb formation" indicated a positive finding of honeycombing on any available follow-up CT. RESULTS Our RA-ILD cohort included patients with probable usual interstitial pneumonia (UIP) (35%), nonspecific interstitial pneumonia (NSIP) (20%), and mixed NSIP/UIP (45%). Among all RA-ILD patients, 16 (40%) showed honeycomb formation on follow-up CT (median time between initial and last follow-up CT was 4.7 years). Patient characteristics and prognosis were not significantly different between the Non-honeycomb and Honeycomb groups. However, Kaplan-Meier survival curve for the time from the date of honeycomb formation to death showed a poor median survival time of 3.2 years. CONCLUSIONS A certain number of patients with RA-ILD developed a honeycomb pattern during long-term follow-up, regardless of whether they had UIP or NSIP. Prognosis in the patients with characteristics of both progressive ILD and honeycomb formation could be poor. Although radiological findings over the disease course and clinical disease behavior in RA-ILD are heterogenous, clinicians should be alert to the possibility of progressive disease and poor prognosis in patients with RA-ILD who form a honeycomb pattern during follow-up observation.

中文翻译：

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放射性蜂窝状对类风湿关节炎相关间质性肺病的影响。

背景技术间质性肺疾病(ILD)是类风湿性关节炎(RA)最常见和最重要的肺部表现。多种形式的间质性肺疾病中都存在放射学蜂窝状图案，可影响生存。然而，RA-ILD 患者蜂窝状图案形成的临床过程和后续放射学变化尚不完全清楚。方法 我们评估了 40 名慢性 RA-ILD 患者的计算机断层扫描结果的连续变化，这些患者在初次诊断时没有蜂窝状图案。我们将患者分为非蜂窝组和蜂窝组，然后分析两组的特征和预后。术语“蜂窝状形成”表示在任何可用的后续 CT 上均积极发现蜂窝状结构。结果我们的 RA-ILD 队列包括疑似普通间质性肺炎 (UIP) (35%)、非特异性间质性肺炎 (NSIP) (20%) 和混合 NSIP/UIP (45%) 的患者。在所有 RA-ILD 患者中，16 例 (40%) 在随访 CT 中显示蜂窝状形成（初次随访与最后一次随访 CT 之间的中位时间为 4.7 年）。非蜂窝组和蜂窝组之间的患者特征和预后没有显着差异。然而，从蜂窝形成之日到死亡的Kaplan-Meier生存曲线显示，中位生存时间较差，为3.2年。结论 一定数量的 RA-ILD 患者在长期随访中出现蜂窝状图案，无论他们是否患有 UIP 或 NSIP。具有进行性 ILD 和蜂窝状形成特征的患者预后可能较差。尽管RA-ILD病程和临床疾病行为的影像学表现存在异质性，但临床医生应警惕在随访观察中形成蜂窝状图案的RA-ILD患者疾病进展和预后不良的可能性。