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Biogenics Research Institute
Other Respiratory Tract Disorders
Hypersensitivity Pneumonitis
Idiopathic Intersitial Lung Disease

 
Histopathology On Lung Biopsy

Histopathological patterns on lung biopsy is the primary mode of classifying patients into the various categories defined in the International Consensus Statement. There are 3 techniques for obtaining lung tissue for pathologic analysis. An open lung biopsy provides the most tissue for analysis, a vidio-assisted thoracoscopic (VATS) technique may also provide the tissue needed to make a diagnosis of usual interstitial pneumonia (UIP) and has less morbidity. A transbronchial biopsy is the third technique which may be adequate for certain diagnoses but is not helpful in making a diagnosis of UIP. It is important to accurately diagnose patients with a histopathologic pattern since the inflammatory response of these patterns determines the rate of fibrosis and destruction to the lung. Interstitial lung disease associated with an organic antigen causation may be arrested, or rendered non-progressive, by an aggressive approach to investigation of the home and workplace environment. Other common interstitial diseases including those associated with autoimmune diseases and sarcoidosis have not been recognized to be caused by organic antigens.

 

Listed are the types of interstitial lung diseases that fit into the major category idiopathic interstitial pneumonia/fibrosis (IIP/F) as defined by the International Consensus Statement. We have also included hypersensitivity pneumonitis, which is not considered of unknown cause, along with chronic eosinophilic pneumonia and pulmonary infiltrate with eosinophilia which we feel are members of this grouping. Sarcoid is included because of similarity to these disorders.

 

Click the for definitions.

 

Acute Interstitial Pneumonia (AIP)
Bronchiolitis Obliterans-Organizing Pneumonia (BOOP)
Bronchiolitis obliterans with organizing pneumonia usually presents with an acute or subacute form of the disorder. Fever, shortness of breath, cough, body aches, and tiredness and fatigue are the most frequently experienced symptoms. The CT scan frequently reveals more extensive lung involvement than the chest x-ray. The lung biopsy shows granulation tissue within small airways and alveolar ducts with associated inflammation in the alveoli. Foci of BOOP may be seen in other forms of interstitial lung disease including non-specific (NSIP) and hypersensitivity pneumonitis (HP). This form of inflammation is responsive to systemic corticosteroids. Mortality is lower than that associated with AIP and UIP. In our series all cases of BOOP were associated with NSIP and microbial contamination was shown to be causative. Remediation was the effective form of treatment.

Chronic Eosinophilic Pneumonia (CEP)
Desquamative Interstitial Pneumonia (DIP)
Hypersensitivity Pneumonitis (HP)
Lymphocytic Interstitial Pneumonia (LIP)
Non-specific Interstitial Pneumonia (NSIP)
Non-biopsied (NB)
Non-classified (NC)
Pulmonary Infiltrate with Eosinophilia (PIE)
Pulmonary Histiocytosis X
Respiratory Bronchiolitis-associated Interstitial Lung Disease (RBILD)
Sarcoid
Usual Interstitial Pneumonia (UIP)