Histopathology of the idiopathic interstitial pneumonias (<scp>IIP</scp>): A review

Tabaj, Gabriela; Fernández, Cristina; Sabbagh, Eduardo; Leslie, Kevin O.

doi:10.1111/resp.12551

Cited by 17 publications

(13 citation statements)

References 35 publications

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“…This was seen in 83.7% (36) of our patients, 74.4% (32 patients) of them showed lymphoplasmacytic infiltration of the airways together with some lymphoid aggregates and 9.3% (four patients) of them showed non- necrotizing granulomatous forms of bronchiolitis. While hypersensitivity pneumonitis (HP) is theoretically in the differential diagnosis of a lymphoid interstitial pneumonia (LIP) pattern, the intensity of lymphoid infiltration is much less in HP and the infiltrates are usually airway-centered even in the presence of airspace dilatation and cyst formation [24]. …”

Section: Discussionmentioning

confidence: 99%

Clinico- pathologic presentation of hypersensitivity pneumonitis in Egyptian patients: a multidisciplinary study

El-Kareem

Akl

Nakhla

et al. 2017

Multidiscip Respir Med

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BackgroundHypersensitivity pneumonitis (HP) is a common diffuse parenchymal lung disease in Egypt which can be difficult to recognize due to the dynamic symptoms & associated environmental factors.MethodsForty-three Egyptian patients were enrolled in this study, presenting with dyspnea and cough, predominant ground-glass opacity (GGO) in high-resolution computed tomography (HRCT) where lung biopsy was needed to establish the diagnosis.ResultsThe age range was 15 to 60 years. Females represented 90.7% (39 patients) while 9.3% (4 patients) of our patients were males. History of contact with birds was detected in 9 (20.9%) patients. Most of our patients (60.5%) didn’t have exposure history, and only 8 patients (18.6%) were living in geographic areas in Egypt that are known for the exposure to environmental etiologic factors (cane sugar exhaust fumes). The most common HRCT pattern was GGO with mosaic parenchyma in 18 patients (41.86%), followed by GGO with centrilobular nodules in 9 patients (20.93%), then isolated diffuse GGO in 5 patients (11.62%), GGO with traction bronchiectasis in 4 patients (9.3%), GGO with consolidation in 3 patients (6.97%), GGO with reticulations in 2 patients (4.65%), and GGO with cysts in 2 patients (4.65%). The most common histologic finding was isolated multinucleated giant cells in 38 patients (88.3%) commonly found in airspaces (24 patients) and less commonly in the interstitium (14 patients), followed by interstitial pneumonia and cellular bronchiolitis in 36 patients (83.7% each), interstitial ill-formed non-necrotizing granulomas in 12 patients (27.9%), fibrosis in 10 patients (23.2%), and organizing pneumonia pattern in 4 patients (9.3%).ConclusionThe diagnosis of HP presenting with predominant GGO pattern in HRCT requires a close interaction among clinicians, radiologists, and pathologists. Some environmental and household factors may be underestimated as etiologic factors. Further environmental and genetic studies are needed especially in patients with negative exposure history.

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Section: Discussionmentioning

confidence: 99%

Clinico- pathologic presentation of hypersensitivity pneumonitis in Egyptian patients: a multidisciplinary study

El-Kareem

Akl

Nakhla

et al. 2017

Multidiscip Respir Med

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“…94 Histologic samples are characterized by patchy proliferation of immature fibroblasts called Masson bodies in a matrix of loose connective tissue involving the terminal airways, alveolar ducts, and alveoli with or without bronchiolar intraluminal polyps. 95 COP most often resolves with several months of corticosteroid therapy and frequently relapses with discontinuation of steroids. In one study of 51 COP cases treated with 1 mg/kg/d prednisolone following HCT, 78% resolved or remained stable and 22% progressed resulting in 16% case fatality.…”

Section: Cryptogenic Organizing Pneumonia/acute Fibrinous Organizing mentioning

confidence: 99%

Early Onset Noninfectious Pulmonary Syndromes after Hematopoietic Cell Transplantation

Vusse

Madtes

2017

Clinics in Chest Medicine

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This article reviews the noninfectious pulmonary syndromes that cause morbidity and mortality early after hematopoietic cell transplantation with an emphasis on risk factors, clinical manifestations, treatment, and outcomes. The first section covers idiopathic pneumonia syndrome and its subtypes: peri-engraftment respiratory distress syndrome, diffuse alveolar hemorrhage, delayed pulmonary toxicity syndrome, and cryptogenic organizing pneumonia. The second section covers pulmonary toxicities of chemotherapies and immunosuppressive agents used in this setting. The final section covers less common syndromes, including pulmonary alveolar proteinosis, venous thromboembolism, pulmonary cytolytic thrombi, pulmonary venoocclusive disease, and transfusion-related acute lung injury.

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“…is characterized by temporal and geographical homogeneity with uniform involvement of the lung parenchyma, mononuclear cell infiltration of the interstitium and relative preservation of lung architecture [133]. The term "non-specific" is used because the histologic appearance of NSIP lacks the characteristic features of UIP, DIP, RB-ILD or AIP.…”

Section: Idiopathic Interstitial Pneumonitismentioning

confidence: 99%

Corticosteroids and Their Use in Respiratory Disorders

Janahi¹,

Rehman²,

Baloch³

2018

Corticosteroids

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Corticosteroids are adrenal hormones that play important physiologic roles including modulation of glucose metabolism, protein catabolism, alteration of calcium metabolism, regulation of bone turnover, suppression of immune system, and down-regulation of the inflammatory cascade. Because of their diverse effects, corticosteroids have been used therapeutically for treating a wide variety of auto-immune, rheumatologic, inflammatory, neoplastic and infectious diseases. In the field of pulmonology, corticosteroids have been used for the treatment of reactive airway diseases (such as asthma and allergic bronchopulmonary aspergillosis), chronic obstructive pulmonary disease, sarcoidosis, collagen vascular diseases (such as vasculitic disorders), eosinophilic pneumonitis, idiopathic interstitial pneumonias and infectious disorders (such as laryngotracheobronchitis). Different formulations of corticosteroids are commercially available including tablets, intravenous injections, intramuscular formulations and inhaled preparations. Long-term use of corticosteroids is often limited by their adverse effects, which include abnormal fat deposition, weight gain, diabetes mellitus, cataracts, glaucoma, osteoporosis, osteonecrosis, elevated risk of fractures, increased susceptibility to infections, proximal myopathy, depression, psychosis, adrenal atrophy with risk of Addisonian crisis, abdominal striae, acne vulgaris, delayed wound healing, easy bruising, electrolyte abnormalities and increased risk of peptic ulcer disease. As our understanding of corticosteroids advances, we may be able to identify individuals at higher risk of experiencing adverse effects.

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Histopathology of the idiopathic interstitial pneumonias (IIP): A review

Cited by 17 publications

References 35 publications

Clinico- pathologic presentation of hypersensitivity pneumonitis in Egyptian patients: a multidisciplinary study

Clinico- pathologic presentation of hypersensitivity pneumonitis in Egyptian patients: a multidisciplinary study

Early Onset Noninfectious Pulmonary Syndromes after Hematopoietic Cell Transplantation

Corticosteroids and Their Use in Respiratory Disorders

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