Desquamative interstitial pneumonia: Risk factors, laboratory and bronchoalveolar lavage findings, radiological and histopathological examination, clinical features, treatment and prognosis (Review)

Abstract

Desquamative interstitial pneumonia is a type of smoking-associated major idiopathic interstitial pneumonia, which is characterized by accumulation of alveolar macrophages in alveolar lumens and septa and develops secondary to mainly active or passive exposure to cigarette smoke. Desquamative interstitial pneumonia mostly occurs in male smokers in association with non-specific symptoms responsive to steroid therapy and has a better prognosis than usual interstitial pneumonia. To date, no large-scale clinical studies have been performed on desquamative interstitial pneumonia patients. Factors responsible for the scarcity of data on the clinical course of this condition include the retrospective nature of the available information as well as its rare occurrence. Despite this, a general consensus exists as to the nature of its symptoms, association with smoking, age and gender distribution, findings of respiratory function tests, steroid responsivity and mortality. The objective of the present review article was to report on desquamative interstitial pneumonia and to describe its etiology, risk factors and clinical features, as well as the laboratory, bronchoalveolar lavage, radiological and histopathological findings, and the treatment and prognosis of affected patients.

Desquamative interstitial pneumonia: a systematic review of its features and outcomes

“…This view is also reflected in the current disease behaviour classification from the guideline, which states that most cases of DIP can at least be stabilised [1]. In addition, other reviews conclude that with treatment most patients remain stable or improve and that complete recovery is possible [4,88]. Survival rates of 90% at 10 years have been reported [78]; however, these prognostications are based on small numbers of patients.…”

Visual and quantitative assessment of HRCT pulmonary changes in idiopathic interstitial pneumonia with PFT correlation

“…The honeycombing is considered the most specific sign of UIP as we noted honeycombing mostly found in UIP than other types of IIP [27] (Fig. 4).…”

Idiopathic desquamative interstitial pneumonia diagnosed using transbronchial lung cryobiopsy: A case report

“…The main feature distinguishing DIP from RB-ILD is the higher intensity of fibrotic changes in the former [ 13 ]. In addition, it can be difficult to distinguish DIP cases from cases of non-specific interstitial pneumonia if the patients are smokers [ 3 ]. Because macrophage aggregates in the alveoli are particularly common in smokers, the degree of fibrosis and the diffuse appearance of macrophage aggregates are important points of distinction.…”

“…Idiopathic DIP has been classified as smoking-related idiopathic interstitial pneumonia along with respiratory bronchiolitis–interstitial lung disease (RB-ILD) [ 2 ]. However, the prevalence of DIP is not known [ 3 ]. This may be due to not only the rarity of the disease but also the necessity of surgical lung biopsy (SLB) for its diagnosis [ 2 ].…”