Difference between revisions of "Desquamative interstitial pneumonia"
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| Line 17: | Line 17: | ||
| Staging = | | Staging = | ||
| Site = [[lung]] - see ''[[diffuse lung diseases]]'' | | Site = [[lung]] - see ''[[diffuse lung diseases]]'' | ||
| Assdx = [[smoking]] | | Assdx = +/-[[smoking]] | ||
| Syndromes = | | Syndromes = | ||
| Clinicalhx = | | Clinicalhx = | ||
| Line 29: | Line 29: | ||
| Other = | | Other = | ||
| ClinDDx = | | ClinDDx = | ||
| Tx = stop smoking | | Tx = stop smoking/remove insult | ||
}} | }} | ||
'''Desquamative interstitial pneumonia''', abbreviated '''DIP''', is a [[diffuse lung diseases|diffuse lung disease]] that is strongly associated with [[smoking]]. | '''Desquamative interstitial pneumonia''', abbreviated '''DIP''', is a [[diffuse lung diseases|diffuse lung disease]] that is strongly associated with [[smoking]]. | ||
| Line 38: | Line 38: | ||
**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> | ||
Diagnosis: | |||
*Requires - surgical biopsy.<ref name=pmid23728865/> | |||
Treatment: | Treatment: | ||
| Line 43: | Line 46: | ||
==Microscopic== | ==Microscopic== | ||
Features: | Features:<ref name=pmid20854463>{{Cite journal | last1 = Tazelaar | first1 = HD. | last2 = Wright | first2 = JL. | last3 = Churg | first3 = A. | title = Desquamative interstitial pneumonia. | journal = Histopathology | volume = 58 | issue = 4 | pages = 509-16 | month = Mar | year = 2011 | doi = 10.1111/j.1365-2559.2010.03649.x | PMID = 20854463 }}</ref> | ||
*Abundant brown pigmented airspace macrophages - ''smoker's macrophages'' - '''key feature'''. | *Abundant brown pigmented airspace macrophages - ''smoker's macrophages'' - '''key feature'''. | ||
* | *Interstitial inflammation ''or'' interstitial fibrosis with preserved architecture preserved - so called "linear fibrosis". | ||
Notes: | Notes: | ||
Revision as of 04:24, 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
- Uncommon.
- Strong association with smoking.[1][2]
- 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.[3]
Diagnosis:
- Requires - surgical biopsy.[3]
Treatment:
- Stop smoking/remove or manage underlying cause.
Microscopic
Features:[4]
- Abundant brown pigmented airspace macrophages - smoker's macrophages - key feature.
- Interstitial inflammation or interstitial fibrosis with preserved architecture preserved - so called "linear fibrosis".
Notes:
- Some fields of view may be indistinguishable from RBILD.
DDx:
Images
Stains
- Macrophages PAS +ve.
See also
References
- ↑ 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.
- ↑ 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.
- ↑ 3.0 3.1 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.
- ↑ 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.