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{{ Infobox diagnosis | |||
| Name = {{PAGENAME}} | |||
| Image = Non-specfic_interstitial_pneumonia_(NSIP),_cellular_variant.jpg | |||
| Width = | |||
| Caption = NSIP. [[H&E stain]]. | |||
| Synonyms = | |||
| Micro = diffuse fibrosis (uniform fibrosis (unlike [[UIP]]), +/-''linear fibrosis'' (fibrosis that follows alveolar walls + no architectural distortion), +/-lymphoid nodules (assoc. with collagen vascular disease), +/-focal [[organizing pneumonia]] | |||
| Subtypes = idiopathic NSIP, NSIP due to an underlying cause | |||
| LMDDx = [[organizing pneumonia]], [[collagen vascular disease]], drug reaction, [[hypersensitivity pneumonitis]], [[lymphocytic interstitial pneumonia]] | |||
| Stains = | |||
| IHC = | |||
| EM = | |||
| Molecular = | |||
| IF = | |||
| Gross = | |||
| Grossing = | |||
| Site = [[lung]] - see ''[[diffuse lung diseases]]'' | |||
| Assdx = | |||
| Syndromes = | |||
| Clinicalhx = | |||
| Signs = cough | |||
| Symptoms = dyspnea | |||
| Prevalence = uncommon | |||
| Bloodwork = | |||
| Rads = lower lung zone fibrosis, patchy ground glass, no honeycombing | |||
| Endoscopy = | |||
| Prognosis = good | |||
| Other = | |||
| ClinDDx = | |||
| Tx = corticosteroids (?) | |||
}} | |||
'''Non-specific interstitial pneumonia''', abbreviated '''NSIP''', is an uncommon type of [[diffuse lung disease]]. | |||
==General== | |||
*Better prognosis than [[UIP]]. | |||
*May respond to corticosteroids.<ref name=pmid22690098>{{cite journal |author=Lee JY, Jin SM, Lee BJ, ''et al.'' |title=Treatment response and long term follow-up results of nonspecific interstitial pneumonia |journal=J. Korean Med. Sci. |volume=27 |issue=6 |pages=661–7 |year=2012 |month=June |pmid=22690098 |pmc=3369453 |doi=10.3346/jkms.2012.27.6.661 |url=}}</ref> | |||
*Some radiologists and pathologists don't believe in this entity.{{fact}} | |||
Associations:<ref name=Ref_WMSP92>{{Ref WMSP|92}}</ref> | |||
*[[Connective tissue disease]].<ref name=pmid21437858>{{cite journal |author=Hauber HP, Bittmann I, Kirsten D |title=[Non-specific interstitial pneumonia (NSIP)] |language=German |journal=Pneumologie |volume=65 |issue=8 |pages=477–83 |year=2011 |month=August |pmid=21437858 |doi=10.1055/s-0030-1256284 |url=}}</ref> | |||
*[[Rheumatoid arthritis]]. | |||
Note: | |||
*If no underlying cause is present it is known as ''idiopathic NSIP''. | |||
Clinical features (typical) of the idiopathic form:<ref name=pmid20178304>{{cite journal |author=Romagnoli M, Poletti V |title=[Update on non-specific interstitial pneumonia: a pattern, a clinical entity or different phenotypes? Surgical or bronchoscopic diagnosis?] |language=Italian |journal=Recenti Prog Med |volume=100 |issue=12 |pages=531–4 |year=2009 |month=December |pmid=20178304 |doi= |url=}}</ref> | |||
*Middle-aged, never-smoker women. | |||
*[[Dyspnea]]. | |||
*Cough. | |||
*Ground glass on HRCT. | |||
*Very good prognosis. | |||
==Gross/Radiology== | |||
*No honeycombing. | |||
*Fibrosis usually lower lung zone. | |||
*Patchy ground glass. | |||
==Microscopic== | |||
Features:<ref name=Ref_WMSP92>{{Ref WMSP|92}}</ref> | |||
*Diffuse fibrosis: | |||
**Uniform fibrosis (unlike [[UIP]]). | |||
**"Linear fibrosis" has a good prognosis - should be mentioned in the report. | |||
***''Linear fibrosis'' = fibrosis that follows alveolar walls + no architectural distortion. | |||
*+/-Lymphoid nodules - association with collagen vascular disease. (???) | |||
*+/-Focal [[organizing pneumonia]]. | |||
Notes: | |||
*Inflammation in NSIP usually more prominent than in UIP. | |||
*No honeycombing - key difference between UIP and NSIP. | |||
DDx: | |||
*[[Collagen vascular disease]]. | |||
*[[Drug reaction]]. | |||
*[[Hypersensitivity pneumonitis]] (extrinic allergic alveolitis). | |||
*[[Lymphocytic interstitial pneumonia]] (LIP) - much more inflammation. | |||
*[[Organizing pneumonia]]. | |||
===Images=== | |||
<gallery> | |||
Image: Non-specfic_interstitial_pneumonia_(NSIP),_cellular_variant.jpg | NSIP - cellular. (WC/Rosen) | |||
Image: Non-specfic_interstitial_pneumonia_(NSIP),_cellular_variant_2.jpg | NSIP - cellular. (WC/Rosen) | |||
Image: Non-specfic interstitial pneumonia (NSIP), fibrosing variant.jpg | NSIP - fibrosing. (WC/Rosen) | |||
Image: Non-specfic interstitial pneumonia (NSIP), fibrosing variant_2.jpg | NSIP - fibrosing. (WC/Rosen) | |||
</gallery> | |||
==See also== | |||
*[[Diffuse lung diseases]]. | |||
==References== | |||
{{Reflist|2}} | |||
[[Category:Diagnosis]] | [[Category:Diagnosis]] | ||
[[Category:Diffuse lung diseases]] |
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