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| ==Lymphocytic interstitial pneumonia== | | ==Lymphocytic interstitial pneumonia== |
| *Often abbreviated '''''LIP'''''. | | *Often abbreviated '''''LIP'''''. |
| ===General===
| | {{Main|Lymphocytic interstitial pneumonia}} |
| *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>
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| *Associated with viral infections ([[HIV]], EBV, human T-cell leukemia virus (HTLV) type 1).
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| **Considered an AIDS-defining diagnosis.<ref>{{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>
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| ===Gross===
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| *Location: basilar predominance.
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| *Increased interstitial markings.
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| ===Microscopic===
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| Features:<ref>URL: [http://emedicine.medscape.com/article/299643-diagnosis http://emedicine.medscape.com/article/299643-diagnosis]. Accessed on: 2 June 2010.</ref>
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| *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.
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| *Plasma cells.
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| *+/-Lymphoid follicles.
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| Negatives:
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| *No [[vasculitis]].
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| *No [[necrosis]].
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| Images:
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| *[http://www.scielo.br/img/revistas/jbpneu/v34n2/en_a02fig01.jpg LIP (scielo.br)].
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| *[http://path.upmc.edu/cases/case176/micro.html LIP (upmc.edu)].
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| DDx:
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| *[[Lymphoma]].
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| *Follicular bronchitis/bronchiolitis.
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| *Nodular lymphoid hyperplasia.
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| **This is determined in part by radiology; it has nodules radiographically.
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| ===Stains===
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| 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>
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| *[[GMS stain]] -ve.
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| *[[Ziehl-Neelsen stain]] -ve.
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| ===IHC===
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| *May be done to exclude lymphoma.
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| ==Respiratory bronchiolitis-interstitial lung disease== | | ==Respiratory bronchiolitis-interstitial lung disease== |
| *Abbreviated ''RB-ILD'' or ''RBILD''. | | *Abbreviated ''RB-ILD'' or ''RBILD''. |
| *[[AKA]] ''respiratory bronchiolitis-associated interstitial lung disease''. | | *[[AKA]] ''respiratory bronchiolitis-associated interstitial lung disease''. |
| | | {{Main|Respiratory bronchiolitis-interstitial lung disease}} |
| ===General===
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| *May be an early version of ''[[DIP]]''.
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| *Associated with smoking.
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| ===Microscopic===
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| Features:<ref name=Ref_PPP197-8>{{Ref PPP|197-8}}</ref>
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| *Brown pigmented airspace macrophages - ''smoker's macrophages'' - '''key feature'''.
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| **Cannot count (distinct) granules.
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| *Inflammation of the terminal bronchioles.
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| Note:
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| *The histologic features of RBILD may be present peri-tumoural.
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| *Hemosiderin-laden macrophages have coarse granules - that one can count.
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| DDx:
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| *[[Desquamative interstitial pneumonia]].
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| ====Image====
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| *[http://www.nature.com/modpathol/journal/v19/n11/fig_tab/3800671f2.html RB-ILD (nature.com)].
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| ==Desquamative interstitial pneumonia== | | ==Desquamative interstitial pneumonia== |
| *Abbreviated ''DIP''. | | *Abbreviated ''DIP''. |
| ===General===
| | {{Main|Desquamative interstitial pneumonia}} |
| *Thought to be advanced ''[[RBILD]]''.
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| *Strong association with smoking.<ref name=Ref_WMSP93>{{Ref WMSP|93}}</ref>
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| **Treatment: stop smoking.
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| ===Microscopic===
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| Features:
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| *Abundant brown pigmented airspace macrophages - ''smoker's macrophages'' - '''key feature'''.
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| *Architecture preserved; "linear fibrosis".
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| Notes:
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| *Some fields of view may be indistinguishable from [[RBILD]].
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| DDx:
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| *Amiodarone toxicity.
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| *Fibrotic [[NSIP]].
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| Images:
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| *[http://pathhsw5m54.ucsf.edu/case27/dip27.html DIP (ucsf.edu)].
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| ===Stains===
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| *Macrophages [[PAS stain|PAS]] +ve.
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| =See also= | | =See also= |