Pathology of Idiopathic Interstitial Pneumonias

Hashisako, Mikiko; Fukuoka, Junya

doi:10.4137/ccrpm.s23320

Cited by 26 publications

(36 citation statements)

References 39 publications

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“…AFOP is a newly recognized histopathological entity of acute lung injury and has been proposed as a possible autonomic interstitial lung disease, although it is not included in the ATS/ERS classification of idiopathic interstitial pneumonias [5]. The pathological hallmark of AFOP was massive cellulose exudate with organization in the alveolar spaces, rather than the fibrous tissue and fibroblast proliferation seen in organizing pneumonia; the numerous eosinophils, macrophage infiltration and eosinophil abscesses formed in eosinophilic pneumonia; or the hyaline membranes seen in diffuse alveolar damage [6][7][8]. It could be idiopathic or could also be associated with infection [9,10], connective tissue disease [11,12], environmental exposures to diverse agents [13], drugs reaction [14], etc ( Table 1).…”

Section: Discussionmentioning

confidence: 99%

Acute Fibrinous and Organizing Pneumonia: A Case Report and Review of the Literature

A¹,

Wang²,

Zhou³

2020

Preprint

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Background Acute fibrinous and organizing pneumonia is an unusual histopathological pattern of acute lung injury. To improve the understanding of acute fibrinous and organizing pneumonia, we herein present one case of a patient with acute fibrinous and organizing pneumonia proven by percutaneous lung biopsy along with clinical features, chest imaging and pathology. Case presentation A 70-year-old man was admitted to our department and was initially diagnosed to have community-acquired pneumonia. He had no specific symptoms and signs on presentation. Chest computed tomography scan showed a high-density shadow in the right basement of the lower lobe. The patient was preliminarily diagnosed with community-acquired pneumonia; however, antibacterial treatment was ineffective. To confirm the diagnosis, we performed twice percutaneous lung biopsy, and pathology was consistent with acute fibrinous and organizing pneumonia. After he was treated with glucocorticoids, the shadow seen on imaging dissipated during the follow-up period. Conclusion Acute fibrinous and organizing pneumonia is a rare histopathological diagnosis, which often has a delay in diagnosis. Clinicians need to consider the possibility of acute fibrinous and organizing pneumonia in the case of invalid antibacterial therapy. Further studies are needed to better classify acute fibrinous and organizing pneumonia, and characterise its clinical presentations, course and treatment.

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Section: Discussionmentioning

confidence: 99%

Acute Fibrinous and Organizing Pneumonia: A Case Report and Review of the Literature

A¹,

Wang²,

Zhou³

2020

Preprint

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“…In addition, NSIP is characterized by a temporal homogeneity of lesions (inflammation and/or fibrosis), which is different from the typical temporal heterogeneity of UIP (7,35,(38)(39)(40)(41). Other features of UIP, such as smooth muscle hyperplasia, fibroblastic foci, and an aggregation of elastic fibers, are not observed in most cases of NSIP (39). In addition, peripheral accentuation is absent or inconspicuous (41).…”

Section: Mimics Of Idiopathic Pulmonary Fibrosismentioning

confidence: 91%

“…NSIP is a type of chronic interstitial pneumonia that is characterized by a relative spatial homogeneity in the involvement of lung parenchyma, which is different from the typical patchy pattern of UIP where regions of the normal lung are interspersed with the affected parenchyma. In addition, NSIP is characterized by a temporal homogeneity of lesions (inflammation and/or fibrosis), which is different from the typical temporal heterogeneity of UIP (7,35,(38)(39)(40)(41). Other features of UIP, such as smooth muscle hyperplasia, fibroblastic foci, and an aggregation of elastic fibers, are not observed in most cases of NSIP (39).…”

Section: Mimics Of Idiopathic Pulmonary Fibrosismentioning

confidence: 92%

Untitled

2019

Clinics

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Idiopathic pulmonary fibrosis is a chronic disease of unknown etiology that usually has a progressive course and is commonly associated with a poor prognosis. The main symptoms of idiopathic pulmonary fibrosis, including progressive dyspnea and dry cough, are often nonspecific. Chest high-resolution computed tomography is the primary modality used in the initial assessment of patients with suspected idiopathic pulmonary fibrosis and may have considerable influence on subsequent management decisions. The main role of computed tomography is to distinguish chronic fibrosing lung diseases with a usual interstitial pneumonia pattern from those presenting with a non-usual interstitial pneumonia pattern, suggesting an alternative diagnosis when possible. A usual interstitial pneumonia pattern on chest tomography is characterized by the presence subpleural and basal predominance, reticular abnormality honeycombing with or without traction bronchiectasis, and the absence of features suggestive of an alternative diagnosis. Idiopathic pulmonary fibrosis can be diagnosed according to clinical and radiological criteria in approximately 66.6% of cases. Confirmation of an idiopathic pulmonary fibrosis diagnosis is challenging, requiring the exclusion of pulmonary fibroses with known causes, such as asbestosis, connective tissue diseases, drug exposure, chronic hypersensitivity pneumonitis, and other forms of idiopathic interstitial pneumonitis. The histopathological hallmark of usual interstitial pneumonia is a heterogeneous appearance, characterized by areas of fibrosis with scarring and honeycombing alternating with areas of less affected or normal parenchyma. The aim of this article was to review the clinical, radiological, and pathological features of idiopathic pulmonary fibrosis and of diseases that might mimic idiopathic pulmonary fibrosis presentation.

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“…However, unlike HP, which occurs in the general population, there is no clear link to pulmonary exposures, such as aerosolized molds [63] or toxic chemicals [64]. Histologically, NSIP is characterized by dense fibrosis with diffuse inflammatory cell infiltration and uniform and diffuse thickening of alveolar walls, but unlike idiopathic pulmonary fibrosis, there is no loss of alveolar integrity [65]. Fibroblastic foci may be present, but are less common in cases of NSIP [66].…”

Section: Clinical and Radiologic Patterns Of Pneumonitismentioning

confidence: 99%

Immune-Related Adverse Events: Pneumonitis

Zhong

Altan

Shannon

et al. 2020

Advances in Experimental Medicine and Biology

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Checkpoint inhibitors are part of the family of immunotherapies and are increasingly being used in a wide variety of cancers. Immunerelated adverse events pose a major challenge in the treatment of cancer patients. Pneumonitis is a rare immune-related adverse event that presents in distinct patterns. The goal of this chapter is to instruct readers on the incidence and clinical manifestations of pneumonitis and to offer guidance in the evaluation and treatment of patients with pneumonitis.

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Pathology of Idiopathic Interstitial Pneumonias

Cited by 26 publications

References 39 publications

Acute Fibrinous and Organizing Pneumonia: A Case Report and Review of the Literature

Acute Fibrinous and Organizing Pneumonia: A Case Report and Review of the Literature

Untitled

Immune-Related Adverse Events: Pneumonitis

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