Smoking-related interstitial fibrosis- a case series.

backgroundSmoking-related interstitial fibrosis (SRIF) is an increasingly recognized entity characterized by localized areas with respiratory bronchiolitis (RB), emphysema and interstitial fibrosis that occurs in smokers or former smokers. First described in 2010, the pathogenesis of SRIF remains unclear, although it is believed to be linked to inflammatory processes derived from smoking. The diagnosis is often accidental through pulmonary parenchyma samples obtained for other purposes, as it is not usually associated with significant respiratory symptoms. Transbronchial lung cryobiopsy (TBLC) is an accurate and safe procedure for diagnosing smoking-related interstitial lung diseases (ILDs). CASE PRESENTATION: This study presents a case series of 13 patients diagnosed with SRIF through TBLC. Patients were predominantly male (76.9%), with a median age of 55 years and a median smoking history of 44 pack-years. Common symptoms included cough (53.8%) and dyspnoea (30.8%), while 38.5% were asymptomatic. Lung Function Tests enclosed normal lung volumes but an impaired diffusion capacity (DL

conclusionsThis case series highlights the mostly indolent nature of SRIF, although progression can occur in a subset of patients. The variability in clinical evolution underscores the importance of accurate diagnosis and individualized follow-up. Further prospective studies with larger cohorts are needed to clarify the natural history of SRIF and guide management strategies. Smoking cessation remains the primary intervention recommended at diagnosis.