Difference between revisions of "Desquamative interstitial pneumonia"

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==General==
==General==
*Uncommon.
*Rare.<ref name=pmid20854463/>
*Strong association with smoking.<ref name=Ref_WMSP93>{{Ref WMSP|93}}</ref><ref name=pmid26324804>{{Cite journal  | last1 = Margaritopoulos | first1 = GA. | last2 = Vasarmidi | first2 = E. | last3 = Jacob | first3 = J. | last4 = Wells | first4 = AU. | last5 = Antoniou | first5 = KM. | title = Smoking and interstitial lung diseases. | journal = Eur Respir Rev | volume = 24 | issue = 137 | pages = 428-35 | month = Sep | year = 2015 | doi = 10.1183/16000617.0050-2015 | PMID = 26324804 }}</ref>
*Strong association with smoking.<ref name=Ref_WMSP93>{{Ref WMSP|93}}</ref><ref name=pmid26324804>{{Cite journal  | last1 = Margaritopoulos | first1 = GA. | last2 = Vasarmidi | first2 = E. | last3 = Jacob | first3 = J. | last4 = Wells | first4 = AU. | last5 = Antoniou | first5 = KM. | title = Smoking and interstitial lung diseases. | journal = Eur Respir Rev | volume = 24 | issue = 137 | pages = 428-35 | month = Sep | year = 2015 | doi = 10.1183/16000617.0050-2015 | PMID = 26324804 }}</ref>  
**Thought to be advanced ''[[RBILD]]''.
**Thought to be advanced ''[[RBILD]]''.
*May be seen in non-smokers (up to ~40% of cases) due to occupational exposures, drugs, viral illnesses and autoimmune diseases.<ref name=pmid23728865>{{Cite journal  | last1 = Godbert | first1 = B. | last2 = Wissler | first2 = MP. | last3 = Vignaud | first3 = JM. | title = Desquamative interstitial pneumonia: an analytic review with an emphasis on aetiology. | journal = Eur Respir Rev | volume = 22 | issue = 128 | pages = 117-23 | month = Jun | year = 2013 | doi = 10.1183/09059180.00005812 | PMID = 23728865 }}</ref>
*May be seen in non-smokers (up to ~40% of cases) due to occupational exposures, drugs, viral illnesses and autoimmune diseases.<ref name=pmid23728865>{{Cite journal  | last1 = Godbert | first1 = B. | last2 = Wissler | first2 = MP. | last3 = Vignaud | first3 = JM. | title = Desquamative interstitial pneumonia: an analytic review with an emphasis on aetiology. | journal = Eur Respir Rev | volume = 22 | issue = 128 | pages = 117-23 | month = Jun | year = 2013 | doi = 10.1183/09059180.00005812 | PMID = 23728865 }}</ref>

Revision as of 04:30, 21 March 2016

Desquamative interstitial pneumonia
Diagnosis in short

LM abundant brown pigmented airspace macrophages (smoker's macrophages), architecture preserved ("linear fibrosis")
LM DDx amiodarone toxicity, fibrotic NSIP, RBILD
Site lung - see diffuse lung diseases

Associated Dx +/-smoking
Prevalence uncommon
Treatment stop smoking/remove insult

Desquamative interstitial pneumonia, abbreviated DIP, is a diffuse lung disease that is strongly associated with smoking.

General

  • Rare.[1]
  • Strong association with smoking.[2][3]
    • Thought to be advanced RBILD.
  • May be seen in non-smokers (up to ~40% of cases) due to occupational exposures, drugs, viral illnesses and autoimmune diseases.[4]

Diagnosis:

  • Requires - surgical biopsy.[4]

Treatment:

  • Stop smoking/remove or manage underlying cause.

Microscopic

Features:[1]

  • Abundant airspace macrophages - usually with brown pigment (so called smoker's macrophages) - key feature.
  • Interstitial inflammation or interstitial fibrosis with a preserved architecture - so called "linear fibrosis".

Notes:

  • Some fields of view may be indistinguishable from RBILD.

DDx:

Images

Stains

  • Macrophages PAS +ve.

See also

References

  1. 1.0 1.1 Tazelaar, HD.; Wright, JL.; Churg, A. (Mar 2011). "Desquamative interstitial pneumonia.". Histopathology 58 (4): 509-16. doi:10.1111/j.1365-2559.2010.03649.x. PMID 20854463.
  2. Humphrey, Peter A; Dehner, Louis P; Pfeifer, John D (2008). The Washington Manual of Surgical Pathology (1st ed.). Lippincott Williams & Wilkins. pp. 93. ISBN 978-0781765275.
  3. Margaritopoulos, GA.; Vasarmidi, E.; Jacob, J.; Wells, AU.; Antoniou, KM. (Sep 2015). "Smoking and interstitial lung diseases.". Eur Respir Rev 24 (137): 428-35. doi:10.1183/16000617.0050-2015. PMID 26324804.
  4. 4.0 4.1 Godbert, B.; Wissler, MP.; Vignaud, JM. (Jun 2013). "Desquamative interstitial pneumonia: an analytic review with an emphasis on aetiology.". Eur Respir Rev 22 (128): 117-23. doi:10.1183/09059180.00005812. PMID 23728865.