Pleuroparenchymal Fibroelastosis: Associations and Underlying Conditions
Farnoosh Tayyari, Tae-Bong Chung and David M. Hwang
Affiliation: Department of Pathology, Toronto General Hospital, Room 11th Floor, 200 Elizabeth Street, Toronto, Ontario, M5G 2C4, Canada.
Keywords: Chronic lung allograft dysfunction, graft versus host disease, interstitial lung disease, pleuroparenchymal
fibroelastosis, pulmonary fibrosis, pulmonary upper lobe fibrosis, restrictive allograft syndrome.
Pleuroparenchymal fibroelastosis (PPFE) is a clinicopathologic entity characterized by clinical presentation
suggestive of a chronic idiopathic interstitial pneumonia, radiologic features of pleural and parenchymal involvement
accentuated in the upper lobes, and a constellation of histologic findings including visceral pleural fibrosis and prominent
fibroelastosis of the subpleural lung parenchyma. While the large majority of cases of PPFE have been considered
idiopathic, development of PPFE in post-bone marrow transplant patients and in lung transplant recipients has recently
been reported. Further, with the growing number of idiopathic PPFE cases reported in the literature, interesting patterns of
association between PPFE and various clinical conditions – including prior treatment for malignancy, autoimmunity,
recurrent infections, and vascular compromise/ischemia – are beginning to emerge. These associations, reviewed here,
may offer clues into the pathogenesis of this rare condition.
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