Lymphocytic interstitial pneumonia

Late pulmonary complications cover a wide spectrum of disorders and include both obstructive and restrictive lung diseases. Included in these disorders are bronchiolitis obliterans with or without organizing pneumonia, diffuse alveolar damage, and lymphocytic interstitial pneumonia. 9,80 xjjgj- py consists of steroids, which are... 

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

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... 

Lymphocytic interstitial pneumonia (LIP) is a benign disorder most commonly associated with CVD (particularly Sjogren s syndrome), Castleman s disease, and diverse autoimmune and immunodeficiency states (including HIV infection) (47 9). Salient CT features of LIP include GGO (100%), centrilobular nodules (86%), interlobular septal thickening (93%), thickened bronchovascular bundles (93%), air cysts (71%), lymph node enlargement (71%), architectural... 

Ichikawa Y, Kinoshita M, Koga T, et al. Lung cyst formation in lymphocytic interstitial pneumonia CT features. J Comput Assist Tomogr 1994 18(5) 745 48. Johkoh T, Ichikado K, Akira M, et al. Lymphocytic interstitial pneumonia followup CT findings in 14 patients. J Thorac Imaging 2000 15(3) 162 167. 

Johkoh T, Muller NL, Pickford HA, et al. Lymphocytic interstitial pneumonia thin-section CT findings in 22 patients. Radiology 1999h 212(2) 567 572. 

Honda O, Johkoh T, Ichikado K, et al. Differential diagnosis of lymphocytic interstitial pneumonia and malignant lymphoma on high-resolution CT. AIR Am J Roentgenol 1999 173(l) 71-74. 

Barbera JA, Hayashi S, Hegele RG, et al. Detection of Epstein-Barr virus in lymphocytic interstitial pneumonia by in situ hybridization. Am Rev Respir Dis 1992 145 940-946. 

Morris JC, Rosen MI, Marchevsky A, et al. Lymphocytic interstitial pneumonia in patients at risk for the acquired immune deficiency syndrome. Chest 1987 91 63-67. 

Baneijee D, Ahmad D. Malignant lymphoma complicating lymphocytic interstitial pneumonia a monoclonal B-ceU neoplasm arising in a polyclonal l3miphoprolifer-ative disorder. Hum Pathol 1982 13 780-782. 

Lymphocytic Interstitial Pneumonia (LIP) and Other Pulmonary Lymphoproliferative Disorders... 

BALT in normal man is sparse, but a striking reactive lymphoid proliferation can occur in disease. These hyperplastic changes can differ in extent and location within the lung. This is the case in reactive lesions such as follicular bronchiolitis, lymphocytic interstitial pneumonia (LIP), and nodular lymphoid hyperplasia (NLH). 

Figure 1 Radiologic appearance of lymphocytic interstitial pneumonia showing a coarse reticular pattern in the lower lohe.

Figure 2 (See color insert.) Lymphocytic interstitial pneumonia. The low magnification view, left panel, shows the diffuse distribution of the interstitial infiltrate, while the high magnification view, right panel, shows abundant interstitial lymphocytes.

Table 2 Differential Diagnosis of Nodular Lymphoid Hyperplasia (NLH), Lymphocytic Interstitial Pneumonia (LIP), Follicular Bronchiolitis (FB), and Extranodal Marginal Zone Lymphoma (Maltoma)... 

The multicenttic variant is characterized by numerous germinal centers, with an interfollicular stroma rich in plasma cells and small vessels. In this variant, the pulmonary parenchyma can also rarely show an associated lymphocytic interstitial pneumonia that is rich in CD138 (syndecan-l)-positive plasma cells (26,110). HHV-8 DNA is often detected in biopsies of lymph nodes from patients with multicentric Castleman disease (27,101,111). There is an interesting report of two patients who had both primary pulmonary hypertension and Castleman disease of these, one had HHV-8 demonstrated in lung tissue (and specifically in the plexiform lesions) (112). 

Nicholson AG. Lymphocytic interstitial pneumonia and other lymphoproliferative disorders in the lung. Semin Respir Crit Care Med 2001 22 409-422. 

Kurosu K, Yumoto N, Furukawa M, et al. Third complementarity-determining-region sequence analysis of lymphocytic interstitial pneumonia most cases demonstrate a minor monoclonal population hidden among normal lymphocyte clones. Am J Respir Crit Care Med 1997 155(4) 1453-1460. 

Kaan P, Hegele R, Hayashi S, et al. Expression of bcl-2 and Epstein-Barr vims LMPl in lymphocytic interstitial pneumonia. Thorax 1997 52(1) 12-16. 

Popa V. Lymphocytic interstitial pneumonia of common variable immunodeficiency. Ann Allergy 1988 60(3) 203-206. 

Chamberlain DW, Hyland RH, Ross DJ. Diphenylhydantoin-induced lymphocytic interstitial pneumonia. Chest 1986 90(3) 458 60. 

Abbreviations-. ILA, interstitial lung disease RA, rheumatoid arthritis SLE, systemic lupus erythematosus SSc, systemic sclerosis DM, dermatomyositis PM, polymyositis SjS, Sjogren s syndrome MCTD, mixed connective tissue disease NSIP, non-specific interstitial pneumonia UIP, usual interstitial pneumonia OP, organizing pneumonia DAD, diffuse alveolar damage DIP, desquamative interstitial pneumonia LIP, lymphocytic interstitial pneumonia. 

Figure 5 (A) and (B) Lymphocytic interstitial pneumonia pattern in a patient with primary Sjogren s syndrome. Alveolar septae are enlarged by a dense mature lymphocytic infiltrate, including a follicle with germinal center. A, HES 40x. The alveolar Hning is entirely preserved. B, HES lOOx.

Johkoh T, Ichikado K, Akira M, et al. Lymphocytic interstitial pneumonia followup CT findings in 14 patients. J Thorac Imaging 2000 15 162-167. 

Diffuse alveolar damage (Acute respiratory distress s3mdrome) Organizing pneumonia Lymphocytic interstitial pneumonia Chronic eosinophilic pneumonia Apical fibrobullous disease Nodules... 

Pleurisy with effusions Exudative pleural effusion Pericarditis with or without effusion Parenchymal lung disease Interstitial lung disease Acute lupus pneumonitis Organizing pneumonia Lymphocytic interstitial pneumonia Diffuse alveolar hemorrhage Airway disease... 

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