Desquamative interstitial pneumonia
| 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 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
- ↑ 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.