Clinical manifestations and prognosis of IPF patients with simple honeycomb wall thickening: A Case Series.

<bold>Background:</bold> Ground glass opacity and consolidation are the main manifestations of chest CT in patients with acute exacerbation of idiopathic pulmonary fibrosis (AE-IPF). However, in some IPF patients, when cough or dyspnea worsened, chest CT only showed honeycomb wall thickening, without ground glass opacity and consolidation. Whether the thickening of honeycomb walls alone also indicates AEIPF is still inconclusive. Methods: This study included 15 IPF patients admitted to our hospital from 2010 to 2023 with worsed clinical symptoms and thickening of honeycomb wall on chest CT. Clinical, laboratory and HRCT data before and after treatment were summarized. Two chest radiologists performed a semi-quantitative analysis of the overall extent of parenchymal abnormalities on CT. <bold>Results:</bold> The average age of the patients was 69 years, 1 female and 14 males. 14 patients had worsed cough and dyspnea, and 4 patients had yellow sputum. All patients were treated with systemic corticosteroids, 12 patients were treated with antibiotics. 13 patients had varying degrees of improvement in oxygenation index after treatment. 12 patients had thinning honeycomb wall after treatment, and 2 patients had no change.9 patients died, 2 within 3 months and 4 within 1 year. <bold>Conclusion:</bold> The thickening of the honeycomb wall is accompanied by the aggravation of respiratory symptoms in IPF patients. After treatment, the honeycomb wall becomes thinner and oxygenation index also rises. Therefore, the thickening of the honeycomb wall alone may also be an imaging manifestation of the acute exacerbation of IPF. However, subsequent comparison with other imaging patterns in AEIPF patients is required.