Difference between revisions of "Lymphocytic interstitial pneumonia"

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#redirect [[Diffuse_lung_diseases#Lymphocytic_interstitial_pneumonia]]
{{ Infobox diagnosis
| Name      = {{PAGENAME}}
| Image      = Lymphocytic interstitial pneumonia -- intermed mag.jpg
| Width      =
| Caption    = Lymphocytic interstitial pneumonia. [[H&E stain]].
| Synonyms  =
| Micro      = small mature lymphocytes in the interstitium of the lung, plasma cells, +/-lymphoid follicles
| Subtypes  =
| LMDDx      = [[lymphoma]] - see ''[[lymphoma of lung]]'', [[follicular bronchitis/bronchiolitis]], [[pulmonary nodular lymphoid hyperplasia|nodular lymphoid hyperplasia]]
| Stains    =
| IHC        =
| EM        =
| Molecular  =
| IF        =
| Gross      =
| Grossing  =
| Staging    =
| Site      = [[lung]] - see ''[[diffuse lung diseases]]''
| Assdx      = autoimmune disorders ([[rheumatoid arthritis]], [[pernicious anemia]], [[Sjoegren syndrome]]), viral infections ([[HIV]], [[EBV]], human T-cell leukemia virus (HTLV) type 1)
| Syndromes  =
| Clinicalhx = dependent on underlying cause - see ''associated diagnoses''
| Signs      =
| Symptoms  =
| Prevalence = rare
| Bloodwork  =
| Rads      = basilar predominance, increased interstitial markings
| Endoscopy  =
| Prognosis  =
| Other      =
| ClinDDx    =
| Tx        =
}}
'''Lymphocytic interstitial pneumonia''' (abbreviated '''LIP'''), also known as '''lymphoid interstitial pneumonia''' and '''lymphocytic interstitial pneumonitis''', is an uncommon [[diffuse lung disease]].


==General==
*Associated with autoimmune disorders ([[rheumatoid arthritis]], [[pernicious anemia]], [[Sjoegren syndrome]])<ref>URL: [http://emedicine.medscape.com/article/299643-overview http://emedicine.medscape.com/article/299643-overview]. Accessed on: 2 June 2010.</ref> and immunodeficiency.<ref name=pmid16088689>{{cite journal |author=Nicholson AG |title=Lymphocytic interstitial pneumonia and other lymphoproliferative disorders in the lung |journal=Semin Respir Crit Care Med |volume=22 |issue=4 |pages=409–22 |year=2001 |month=August |pmid=16088689 |doi=10.1055/s-2001-17384 |url=}}</ref>
*Associated with viral infections ([[HIV]], [[EBV]], human T-cell leukemia virus (HTLV) type 1).
**Considered an AIDS-defining diagnosis.<ref name=pmid7893443>{{Cite journal  | last1 = Turner | first1 = BJ. | last2 = Eppes | first2 = S. | last3 = McKee | first3 = LJ. | last4 = Cosler | first4 = L. | last5 = Markson | first5 = LE. | title = A population-based comparison of the clinical course of children and adults with AIDS. | journal = AIDS | volume = 9 | issue = 1 | pages = 65-72 | month = Jan | year = 1995 | doi =  | PMID = 7893443 }}</ref>
==Gross==
*Location: basilar predominance.
*Increased interstitial markings.
==Microscopic==
Features:<ref>URL: [http://emedicine.medscape.com/article/299643-diagnosis http://emedicine.medscape.com/article/299643-diagnosis]. Accessed on: 2 June 2010.</ref>
*Small mature lymphocytes (usually B cells)<ref name=afip_vol2_265>AFIP atlas of nontumour pathology. 2002. Vo. 2. P.265. ISBN 1-881041-79-4.</ref> in the interstitium of the lung.
*Plasma cells.
*+/-Lymphoid follicles.
Negatives:
*No [[vasculitis]].
*No [[necrosis]].
DDx:
*[[Lymphoma]].
*[[Follicular bronchitis/bronchiolitis]].
*[[Pulmonary nodular lymphoid hyperplasia|Nodular lymphoid hyperplasia]].
**This is determined in part by radiology; it has nodules radiographically.
*[[Non-specific interstitial pneumonia]] - less inflammation.
===Images===
====Case====
<gallery>
Image: Lymphocytic interstitial pneumonia -- extremely low mag.jpg | LIP - ext. low mag. (WC/Nephron)
Image: Lymphocytic interstitial pneumonia -- very low mag.jpg | LIP - very low mag. (WC/Nephron)
Image: Lymphocytic interstitial pneumonia -- low mag.jpg | LIP - low mag. (WC/Nephron)
Image: Lymphocytic interstitial pneumonia -- intermed mag.jpg | LIP - intermed. mag. (WC/Nephron)
Image: Lymphocytic interstitial pneumonia -- high mag.jpg | LIP - high mag. (WC/Nephron)
Image: Lymphocytic interstitial pneumonia -- very high mag.jpg | LIP - very high mag. (WC/Nephron)
<gallery/>
<gallery>
Image: Lymphocytic interstitial pneumonia and normal -- very low mag.jpg | LIP & normal - very low mag. (WC/Nephron)
Image: Lymphocytic interstitial pneumonia and normal -- low mag.jpg | LIP & normal - low mag. (WC/Nephron)
Image: Lymphocytic interstitial pneumonia and normal - alt -- low mag.jpg | LIP & normal - low mag. (WC/Nephron)
Image: Lymphocytic interstitial pneumonia and normal -- intermed mag.jpg | LIP & normal - intermed mag. (WC/Nephron)
Image: Lymphocytic interstitial pneumonia and normal -- high mag.jpg | LIP & normal - high mag. (WC/Nephron)
</gallery>
====www====
*[http://www.scielo.br/img/revistas/jbpneu/v34n2/en_a02fig01.jpg LIP (scielo.br)].
*[http://path.upmc.edu/cases/case176/micro.html LIP (upmc.edu)].
==Stains==
To exclude infection:<ref>URL: [http://path.upmc.edu/cases/case176/dx.html http://path.upmc.edu/cases/case176/dx.html]. Accessed on: 8 January 2012.</ref>
*[[GMS stain]] -ve.
*[[Ziehl-Neelsen stain]] -ve.
==IHC==
*May be done to exclude lymphoma.
==See also==
*[[Diffuse lung diseases]].
==References==
{{Reflist|2}}
[[Category:Diffuse lung diseases]]
[[Category:Diagnosis]]
[[Category:Diagnosis]]

Latest revision as of 13:30, 10 May 2016

Lymphocytic interstitial pneumonia (abbreviated LIP), also known as lymphoid interstitial pneumonia and lymphocytic interstitial pneumonitis, is an uncommon diffuse lung disease.

Lymphocytic interstitial pneumonia
Diagnosis in short
Template:Px
Lymphocytic interstitial pneumonia. H&E stain.
LM small mature lymphocytes in the interstitium of the lung, plasma cells, +/-lymphoid follicles
LM DDx lymphoma - see lymphoma of lung, follicular bronchitis/bronchiolitis, nodular lymphoid hyperplasia
Site lung - see diffuse lung diseases
Associated Dx autoimmune disorders (rheumatoid arthritis, pernicious anemia, Sjoegren syndrome), viral infections (HIV, EBV, human T-cell leukemia virus (HTLV) type 1)
Clinical history dependent on underlying cause - see associated diagnoses
Prevalence rare
Radiology basilar predominance, increased interstitial markings

General

Gross

  • Location: basilar predominance.
  • Increased interstitial markings.

Microscopic

Features:[4]

  • Small mature lymphocytes (usually B cells)[5] in the interstitium of the lung.
  • Plasma cells.
  • +/-Lymphoid follicles.

Negatives:

DDx:

Images

Case

  • Lymphocytic interstitial pneumonia -- extremely low mag.jpg

    LIP - ext. low mag. (WC/Nephron)

  • Lymphocytic interstitial pneumonia -- very low mag.jpg

    LIP - very low mag. (WC/Nephron)

  • Lymphocytic interstitial pneumonia -- low mag.jpg

    LIP - low mag. (WC/Nephron)

  • Lymphocytic interstitial pneumonia -- intermed mag.jpg

    LIP - intermed. mag. (WC/Nephron)

  • Lymphocytic interstitial pneumonia -- high mag.jpg

    LIP - high mag. (WC/Nephron)

  • Lymphocytic interstitial pneumonia -- very high mag.jpg

    LIP - very high mag. (WC/Nephron)

  • Lymphocytic interstitial pneumonia and normal -- very low mag.jpg

    LIP & normal - very low mag. (WC/Nephron)

  • Lymphocytic interstitial pneumonia and normal -- low mag.jpg

    LIP & normal - low mag. (WC/Nephron)

  • Lymphocytic interstitial pneumonia and normal - alt -- low mag.jpg

    LIP & normal - low mag. (WC/Nephron)

  • Lymphocytic interstitial pneumonia and normal -- intermed mag.jpg

    LIP & normal - intermed mag. (WC/Nephron)

  • Lymphocytic interstitial pneumonia and normal -- high mag.jpg

    LIP & normal - high mag. (WC/Nephron)

www

Stains

To exclude infection:[6]

IHC

  • May be done to exclude lymphoma.

See also

References

  1. ↑ URL: http://emedicine.medscape.com/article/299643-overview. Accessed on: 2 June 2010.
  2. ↑ Nicholson AG (August 2001). "Lymphocytic interstitial pneumonia and other lymphoproliferative disorders in the lung". Semin Respir Crit Care Med 22 (4): 409–22. doi:10.1055/s-2001-17384. PMID 16088689.
  3. ↑ Turner, BJ.; Eppes, S.; McKee, LJ.; Cosler, L.; Markson, LE. (Jan 1995). "A population-based comparison of the clinical course of children and adults with AIDS.". AIDS 9 (1): 65-72. PMID 7893443.
  4. ↑ URL: http://emedicine.medscape.com/article/299643-diagnosis. Accessed on: 2 June 2010.
  5. ↑ AFIP atlas of nontumour pathology. 2002. Vo. 2. P.265. ISBN 1-881041-79-4.
  6. ↑ URL: http://path.upmc.edu/cases/case176/dx.html. Accessed on: 8 January 2012.
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