Histological Diagnoses of Military Personnel Undergoing Lung Biopsy After Deployment to Southwest Asia

• Published in: Lung 2017-08, Vol.195 (4), p.507-515
• Main Authors: Madar, Cristian S., Lewin-Smith, Michael R., Franks, Teri J., Harley, Russell A., Klaric, John S., Morris, Michael J.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; African Americans; Age; Armed forces; Biopsy; Bronchiolitis Obliterans - ethnology; Bronchiolitis Obliterans - pathology; Bronchopneumonia; Chi-Square Distribution; Constrictions; Data processing; European Continental Ancestry Group; Female; Granuloma, Respiratory Tract - ethnology; Granuloma, Respiratory Tract - pathology; Humans; Idiopathic Interstitial Pneumonias - ethnology; Idiopathic Interstitial Pneumonias - pathology; Logistic Models; Lung - pathology; Lung diseases; Lung Diseases - ethnology; Lung Diseases - pathology; Male; Medical diagnosis; Medicine; Medicine & Public Health; Middle Aged; Middle East; Military; Military deployment; Military Personnel; Minority & ethnic groups; Multivariate Analysis; Obstructive lung disease; Odds Ratio; Pathology; Patients; Pneumology/Respiratory System; Pneumonia; Predictive Value of Tests; Prevalence; Respiratory tract diseases; Retrospective Studies; Risk Factors; United States - epidemiology; Young Adult
• ISSN: 0341-2040; 1432-1750
• DOI: 10.1007/s00408-017-0009-2

Introduction The current understanding of associations between lung disease and military deployment to Southwest Asia, including Iraq and Afghanistan, is both controversial and limited. We sought to clarify the relation between military deployment and biopsy-proven lung disease. Methods Retrospective data were analyzed for military personnel with non-neoplastic lung biopsies evaluated at the Armed Forces Institute of Pathology or Joint Pathology Center (January 2005 to December 2012). Results Of 391 subjects, 137 (35.0%) had deployed to Southwest Asia prior to biopsy. Compared to non-deployed subjects, those deployed were younger (median age 37 vs. 51 years) with higher representation of African Americans (30.0 vs. 16.9%). Deployed patients were more likely diagnosed with non-necrotizing granulomas (OR 2.4). Non-deployed subjects had higher frequency of idiopathic interstitial pneumonias, particularly organizing pneumonia. Prevalence of small airways diseases including constrictive bronchiolitis was low. Conclusions This study provides a broader understanding of diversity of biopsy-proven non-neoplastic lung disease as it relates to military deployment to Southwest Asia and importantly did not show an increased prevalence of small airway disease to include constrictive bronchiolitis.