Interstitial pneumonia fibrosis

Katzenstein AL, Fiorelli RF. Nonspecific interstitial pneumonia/fibrosis histologic features and chnical significance. Am J Surg Pathol 1994 18 136-147. 

Nanki N, Fujita J, Yamaji Y, et al. Nonspecific interstitial pneumonia/fibrosis completely recovered by adding cyclophosphamide to corticosteroids. Intern Med 2002 41 867-870. 

Nishiyama O, Kondoh Y, Taniguchi H, et al. Serial high resolution CT findings in nonspecific interstitial pneumonia/fibrosis. J Comput Assist Tomogr 2000 24(1) 41 6. 

Nagai S, Kitaichi M, Itoh H, et al. Idiopathic nonspecific interstitial pneumonia/ fibrosis comparison with idiopathic pulmonary fibrosis and BOOP. Eur Respir J 1998 12 1010-1019. 

Park C, Jeon J, Park S, et al. Nonspecific interstitial pneumonia/fibrosis clinical manifestations, histologic and radiologic features. Korean J Intern Med 19% 11 122-132. 

Katsura S, Martin CJ (1967) The roentgenologic diagnosis of anatomic emphysema. Am Rev Respir Dis 96 700-706 Katzenstein AA, Fiorelli RF (1994) Non-specific interstitial pneumonia/fibrosis histologic features and clinical significance. Am J Surg Pathol 18 136-147 Kerley P (1936) Discussion on emphysema. Proc R Soc Med 29 1307-1324... 

The thickness of the blood-gas interface is normally less than 0.5 (im. This extremely thin barrier promotes the diffusion of gases. The thickness may increase, however, under conditions of interstitial fibrosis, interstitial edema, and pneumonia. Fibrosis involves the excess production of collagen fibers by fibroblasts in the interstitial space. Edema is the movement of fluid from the capillaries into the interstitial space. Pneumonia causes inflammation and alveolar flooding. In each case, the thickness of the barrier between the air and the blood is increased and diffusion is impaired. 

A few chemotherapeutic agents accumulate in endocytic vesicles probably due to their size and/or charge. Bleomycin (BLM, MW 1.400) is a chemotherapeutic drug approved for the treatment of many forms of cancer. The applicability of bleomycin is, however, limited by the adverse effects of the treatment, especially interstitial pneumonia causing irreversible lung fibrosis in 3% of the treated patients... 

Mogulkoc N, Brutsche MH, Bishop PW, Murby B, Greaves MS, Horrocks AW, Wilson M, McCullough C, Prescott M, Egan JJ Greater Manchester Pulmonary Fibrosis Consortium. Pulmonary (99m)Tc-DTPA aerosol clearance and survival in usual interstitial pneumonia (UIP). Thorax 2001 56(12) 916-23. 

CHRONIC HEALTH RISKS asthma chronic obstructive lung disease pulmonary fibrosis chronic interstitial pneumonia dyspnea coughing shortness of breath renal failure seizures coma death. 

Interstitial Lung Diseases That Have No Known Cause 338 Idiopathic Interstitial Pneumonias 33S Idiopathic Pulmonary Fibrosis 339 Nonspecific Interstitial Pneumonia 339 Cryptogenic Organizing Pneumonia 339... 

The term idiopathic interstitial pneumonias refers to a group of seven entities with distinct histologic patterns idiopathic pulmonary fibrosis (IFF), characterized by the pattern of usual interstitial pneumonia (UIP) nonspecific interstitial pneumonia (NSIP) cryptogenic organizing pneumonia (COP) respiratory bron-chiohtis-associated interstitial lung disease (RB-ILD) desquamative interstitial pneumonia (DIP) lymphoid interstitial pneumonia (LIP) and acute interstitial pneumonia (AIP). 

Fig. 26.4a,b. Axial CT image in a 63-year-old man with usual interstitial pneumonia (UIP)/idiopathic pulmonary fibrosis (IPF) shows bilateral reticular opacities, honeycombing (black arrowheads), and traction bronchiectasis (arrow). In addition, patchy, ground-glass opacities are present (white arrowhead) (a). Acute exacerbation in the same patient shows marked progression of ground-glass opacities (arrowheads) (b)... 

Idiopathic pulmonary fibrosis Nonspecific interstitial pneumonia Cryptogenic organizing pneumonia Desquamative interstitial pneumonia Respiratory bronchioUtis-associated interstitial lung disease Lymphocytic interstitial pneumonia Acnte interstitial pnemnonia... 

Gotway MB, Freemer MM, King TE Jr. Challenges in pulmonary fibrosis 1 use of high resolution CT scanning of the lung for the evaluation of patients with idiopathic interstitial pneumonias. Thorax 2007 62 546-553. 

Usual interstitial pneumonia Nonspecific interstitial pneumonia Organizing pneumonia Diffuse alveolar damage Respiratory bronchiolitis Desquamative interstitial pneumonia Lymphocytic interstitial pneumonia Idiopathic pulmonary fibrosis/cryptogenic fibrosing alveolitis Nonspecific interstitial pneumonia (provisional) Cryptogenic organizing pneumonia Acute interstitial pneumonia Respiratory bronchiolitis-associated interstitial lung disease Desquamative interstitial pneumonia Lymphocytic interstitial pneumonia... 

Park JS, Lee KS, Kim JS, et al. Nonspecific interstitial pneumonia with fibrosis radiographic and CT findings in seven patients. Radiology 1995 195(3) 645-648. 

Kim T, Lee K, Chung M, et al. Nonspecific interstitial pneumonia with fibrosis high resolution CT and pathologic findings. AJR Am J Roentgenol 1998 171 1645-1650. 

The lymphoplasmacytic interstitial infiltrates seen in UIP are generally sparse in comparison to other entities such as nonspecific interstitial pneumonia (NSIP) or hypersensitivity pneumonitis (HP). Extensive cellular infiltrates or follicular lymphoid hyperplasia should lead to consideration of other entities that may cause a UIP pattern of fibrosis such as CVD or HP. Pleural inflammation is not a feature of idiopathic UIP, and its presence indicates a second process or secondary form of UIP with pleuritis, most likely a CVD such as rheumatoid arthritis (RA) or systemic lupus erythematosus (SUE) (14). 

The term nonspecific interstitial pneumonia (NSIP) was coined by Katzenstein and Fiorelli in 1994 to account for a pattern of interstitial fibrosis that appeared to have distinct features from UIP. Notably, it was observed that in some patients the interstitial process was more cellular than was typical for UIP and the characteristic features of spatial and temporal heterogeneity were not seen. Therefore, a new term, NSIP, was introduced (19). 

Figure 2 (See color insert.) Nonspecific interstitial pneumonia. (A) NSIP fibrotic pattern interstitial fibrosis in a temporally and spatially homogeneous pattern (original magnification, 20x Masson s trichrome stain). (B) NSIP cellular pattern interstitial lymphocytic infiltrates in a temporally and spatially homogeneous pattern (original magnification, 40 x H E stain). (C) NSIP fibrotic pattern interstitial fibrosis in a temporally and spatially homogeneous pattern (original magnification, 200x H E stain). Abbreviation-. NSIP, nonspecific interstitial pneumonia.

For pulmonary fibrosis, the role of CS is unclear (23,24). Early studies suggested a steroid-responsive group (25-27). However, with the new classification system that separates IFF from nonspecific interstitial pneumonia (NSIF), it is reasonable to assume that most steroid responsive cases of IFF were in fact cellular NSIF and that CSs have no impact on the chronic phase of IFF (14,23,28). However, CSs may have a role in treating acute exacerbations of IFF (29). 

Kondoh Y, Taniguchi H, Yokoi T, et al. Cyclophosphamide and low-dose prednisolone in idiopathic pulmonary fibrosis and fibrosing nonspecific interstitial pneumonia. Eur Respir J 2005 25 528-533. 

Grgic A, Lausberg H, Heinrich M, et al. Progression of fibrosis in usual interstitial pneumonia serial evaluation of the native lung after single lung transplantation. Respiration 2007 (e-Published). 

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