Lymphocytic Interstitial Pneumonia and Other Lymphoproliferative Disorders in the Lung

Abstract

Lymphocytic interstitial pneumonia (LIP) is a clinicopathologic term that relates histologically to a dense interstitial infiltrate of mainly T cells, plasma cells, and histiocytes, with germinal centers often identified. Its precise etiology is unknown, but there are strong clinical associations with several autoimmune disorders, as well as both congenital and acquired immunodeficiency syndromes. It may overlap histologically with both extrinsic allergic alveolitis and nonspecific interstitial pneumonia, and therefore close clinical/radiological association is essential for diagnosis. LIP also overlaps clinically and histologically with follicular bronchitis/bronchiolitis, the latter showing reactive lymphoid hyperplasia with a peribronchiolar distribution predominantly comprising lymphoid follicles. LIP may also be histologically indistinguishable from nodular lymphoid hyperplasia and lymphomas arising from mucosa-associated lymphoid tissue (MALT) but can usually be differentiated via analysis of clinical and imaging data plus assessment of immunohistochemistry and gene rearrangement studies. Other entities include lymphomatoid granulomatosis, intravascular lymphomatosis, Castleman's disease, primary pleural lymphomas, primary effusion lymphomas, plasmacytomas, and secondary involvement by lymphoma, but these should all be readily distinguishable from lymphocytic interstitial pneumonia if all clinical, imaging, and histological data are apparent.

Task force on chronic interstitial lung disease in immunocompetent children

“…Cellular intersititial pneumonitis of infants appears histologically similar to nonspecific interstitial pneumonia in adults [76]. Chronic pneumonitis of infancy has a distinct histological pattern showing florid type 2 cell hyperplasia and diffuse expansion of the interstitium by fibroblastic tissue with comparatively little inflammation [74,75,77]. Acellular intra-alveolar material resembling that seen in alveolar proteinosis is a frequent finding.…”

“…It is a well described complication of paediatric AIDS and occurs in w30% of children perinatally affected by HIV. Familial cases are also described [74].…”

Padrões tomográficos das doenças intersticiais pulmonares difusas com correlação clínica e patológica

“…(42) A surgical lung biopsy from a patient with sarcoidosis is presented in noglobulin deficiency, Sjögren's syndrome, or mixed autoimmune disease with Sjögren's syndrome. (44,45) Amyloidosis Amyloidosis is a disorder of immunoglobulin protein folding in which normally soluble plasma proteins aggregate as an insoluble abnormal fibrillar form causing progressive disruption to tissue structure and organ function. Diffuse amyloid deposition within the lung parenchyma is usually associated with involvement of other organs systems.…”

Idiopathic Lymphoid Interstitial Pneumonia: A Case Report

“…These findings confirm with the international literature. Granuloma formation, intra-alveolar organization or macrophage accumulation which have been described in the literature, was not seen in our patient [11,12].…”