Idiopathic interstitial pneumonia


Idiopathic interstitial pneumonia IIP, or noninfectious pneumonia1 are a class of diffuse lung diseases These diseases typically affect the pulmonary interstitium, although some also have a component affecting the airways for instance, Cryptogenic organizing pneumonitis There are seven recognized distinct subtypes of IIP

Histologic classificationedit

Classification can be complex,2 and the combined efforts of clinicians, radiologists, and pathologists can help in the generation of a more specific diagnosis34

Idiopathic interstitial pneumonia can be subclassified based on histologic appearance into the following patterns:56

Histology Clinical Correlates
Desquamative interstitial pneumonia DIP DIP
Diffuse alveolar damage DAD ARDS, AIP, TRALI
Nonspecific interstitial pneumonia NSIP NSIP
Respiratory bronchiolitis RB-ILD
Usual interstitial pneumonia UIP CVD, IPF, drug toxicity, pneumoconiosis
Organizing pneumonia Cryptogenic organizing pneumonia
Lymphoid interstitial pneumonia LIP LIP

Usual interstitial pneumonia is the most common type7

Developmentedit

Table 1: Development of the histologic idiopathic interstitial pneumonia classification

      Leibow et al 1969   Katzenstein 19988   ATS/ERS 20026
                           
                UIP   UIP
     
                             
      UIP     DAD   DAD
     
                             
                NSIP   NSIP
   
                           
      DIP   DIP/RB   DIP
     
                             
                        RB
 
                           
      BIP   OP   OP
   
                           
      LIP   LPD   LIP
   
                           
      GIP   HMF   HMF
   

UIP=usual interstitial pneumonia; DAD=diffuse alveolar damage; NSIP=non-specific interstitial pneumonia; DIP=desquamative interstitial pneumonia; RB=respiratory bronchiolitis; BIP=bronchiolitis obliterans interstitial pneumonia; OP=organizing pneumonia; LIP=lymphoid interstitial pneumonia; LPD=lymphoproliferative disease not considered a diffuse lung disease; GIP=giant cell interstitial pneumonia; HMF=heavy metal fibrosis, no longer grouped with diffuse lung disease

Lymphoid interstitial pneumonia was originally included in this category, then excluded, then included again9

Referencesedit

  1. ^ Clinical infectious diseases : a practical approach New York, NY ua: Oxford Univ Press 1999 p 833 ISBN 978-0-19-508103-9  |first1= missing |last1= in Authors list helpCS1 maint: Extra text: authors list link
  2. ^ Nicholson AG November 2002 "Classification of idiopathic interstitial pneumonias: making sense of the alphabet soup" Histopathology 41 5: 381–91 PMID 12405906 doi:101046/j1365-2559200201421x 
  3. ^ Flaherty KR, King TE, Raghu G, et al October 2004 "Idiopathic interstitial pneumonia: what is the effect of a multidisciplinary approach to diagnosis" Am J Respir Crit Care Med 170 8: 904–10 PMID 15256390 doi:101164/rccm200402-147OC 
  4. ^ Kim DS, Collard HR, King TE June 2006 "Classification and natural history of the idiopathic interstitial pneumonias" Proc Am Thorac Soc 3 4: 285–92 PMC 2658683  PMID 16738191 doi:101513/pats200601-005TK 
  5. ^ Leslie KO, Wick MR Practical Pulmonary Pathology: A Diagnostic Approach Elsevier Inc 2005 ISBN 978-0-443-06631-3
  6. ^ a b American Thoracic, Society; European Respiratory, Society January 2002 "American Thoracic Society/European Respiratory Society International Multidisciplinary Consensus Classification of the Idiopathic Interstitial Pneumonias This joint statement of the American Thoracic Society ATS, and the European Respiratory Society ERS was adopted by the ATS board of directors, June 2001 and by the ERS Executive Committee, June 2001" Am J Respir Crit Care Med 165 2: 277–304 PMID 11790668 doi:101164/ajrccm1652ats01 
  7. ^ Visscher DW, Myers JL June 2006 "Histologic spectrum of idiopathic interstitial pneumonias" Proc Am Thorac Soc 3 4: 322–9 PMID 16738196 doi:101513/pats200602-019TK 
  8. ^ Katzenstein AL, Myers JL 1998 "Idiopathic pulmonary fibrosis: clinical relevance of pathologic classification" Am J Respir Crit Care Med 157 4 Pt 1: 1301–15 PMID 9563754 doi:101164/ajrccm15749707039 
  9. ^ Swigris JJ, Berry GJ, Raffin TA, Kuschner WG December 2002 "Lymphoid interstitial pneumonia: a narrative review" Chest 122 6: 2150–64 PMID 12475860 doi:101378/chest12262150 


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