scholarly journals Pathology of Idiopathic Interstitial Pneumonias

Author(s):  
Mikiko Hashisako ◽  
Junya Fukuoka

The updated classification of idiopathic interstitial pneumonias (IIPs) in 2013 by American Thoracic Society/European Respiratory Society included several important revisions to the categories described in the 2002 classification. In the updated classification, lymphoid interstitial pneumonia (LIP) was moved from major to rare IIPs, pleuroparenchymal fibroelastosis (PPFE) was newly included in the rare IIPs, acute fibrinous and organizing pneumonia (AFOP) and interstitial pneumonias with a bronchiolocentric distribution are recognized as rare histologic patterns, and unclassifiable IIP (UCIP) was classified as an IIP. However, recent reports indicate the areas of concern that may require further evaluation. Here, we describe the histopathologic features of the updated IIPs and their rare histologic patterns and also point out some of the issues to be considered in this context.

2018 ◽  
Vol 51 (5) ◽  
pp. 321-327 ◽  
Author(s):  
Daniel Simões Oliveira ◽  
José de Arimatéia Araújo Filho ◽  
Antonio Fernando Lins Paiva ◽  
Eduardo Seigo Ikari ◽  
Rodrigo Caruso Chate ◽  
...  

Abstract The diagnosis of idiopathic interstitial pneumonias (IIPs) involves a multidisciplinary scenario in which the radiologist assumes a key role. The latest (2013) update of the IIP classification by the American Thoracic Society/European Respiratory Society proposed some important changes to the original classification of 2002. The novelties include the addition of a new disease (idiopathic pleuroparenchymal fibroelastosis) and the subdivision of the IIPs into four main groups: chronic fibrosing IIPs (idiopathic pulmonary fibrosis and nonspecific interstitial pneumonia); smoking-related IIPs (desquamative interstitial pneumonia and respiratory bronchiolitis-associated interstitial lung disease); acute or subacute IIPs (cryptogenic organizing pneumonia and acute interstitial pneumonia); rare IIPs (lymphoid interstitial pneumonia and idiopathic pleuroparenchymal fibroelastosis); and the so-called “unclassifiable” IIPs. In this study, we review the main clinical, tomographic, and pathological characteristics of each IIP.


2018 ◽  
Vol 142 (9) ◽  
pp. 1069-1079 ◽  
Author(s):  
Tomonori Tanaka ◽  
Kaori Ishida

Context.— In 2013, the revised American Thoracic Society and European Respiratory Society classification of idiopathic interstitial pneumonias (IIPs) described 2 rare IIPs and 2 rare histologic patterns. Because of the rarity of the disease, there is limited evidence related to the histology. Because the rare histologic patterns are provisional criteria, no unanimous consensus on histologic diagnostic criteria has yet been reached. Objective.— To review the histologic features for rare IIPs and rare histologic patterns, and to provide diagnostic aids and discuss the differential diagnosis. Data Sources.— Published peer-reviewed literature and the authors' personal experience. Conclusions.— Following the publication of the international consensus classification, evidence regarding rare IIPs and rare histologic patterns has accumulated to some extent, although to date the amount remains insufficient and further evidence is required. Because the diagnosis is sometimes challenging, a multidisciplinary approach represents the gold standard in reaching an accurate diagnosis for these rare disorders.


Radiographics ◽  
2015 ◽  
Vol 35 (7) ◽  
pp. 1849-1871 ◽  
Author(s):  
Nicola Sverzellati ◽  
David A. Lynch ◽  
David M. Hansell ◽  
Takeshi Johkoh ◽  
Talmadge E. King ◽  
...  

Chest Imaging ◽  
2019 ◽  
pp. 449-451
Author(s):  
Sanjeev Bhalla

The idiopathic interstitial pneumonias (IIPs) are a group of diffuse lung diseases that often manifest clinically with increasing dyspnea and hypoxemia. In the most recent revision of the American Thoracic Society/European Respiratory Society statement on IIPs, the major IIPs are divided into 3 groups: chronic fibrosing conditions (usual interstitial pneumonia and nonspecific interstitial pneumonia); smoking-related conditions (respiratory bronchiolitis and desquamative interstitial pneumonia) and acute/subacute IIPs (cryptogenic organizing pneumonia and acute interstitial pneumonia). Although some of these patterns may be seen with other conditions (e.g, NSIP with collagen vascular disease), the term IIP only refers to the idiopathic variants. Interestingly, the smoking-related conditions (RB-ILD and DIP) are included in this idiopathic grouping despite their association with cigarette use.


2015 ◽  
Vol 2015 ◽  
pp. 1-9 ◽  
Author(s):  
Karina Portillo ◽  
Ignasi Guasch ◽  
Caroline Becker ◽  
Felipe Andreo ◽  
Maria Teresa Fernández-Figueras ◽  
...  

Pleuroparenchymal fibroelastosis (PPFE) is a rare entity that has been recently included in the official American Thoracic Society/European Respiratory Society (ATS/ERS) statement in 2013 as a group of rare idiopathic interstitial pneumonias (IIPs). PPFE is characterized by pleural and subpleural parenchymal thickening due to elastic fiber proliferation, mainly in the upper lobes. The etiology of the disease is unclear, although some cases have been associated as a complication after bone marrow transplantation, lung transplantation (LT), chemotherapy, and recurrent respiratory infections. The patients usually report progressive dyspnea and dry cough and are predisposed to develop spontaneous or iatrogenic pneumothoraces after surgical lung biopsy (SLB) for its diagnosis. That is why better awareness with the clinical and radiologic features can help optimal management by the multidisciplinary team. Novel invasive techniques such as cryobiopsy may become useful tools in these patients as it could spare SLB. We present the first reported cases in Spain.


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