Usual interstitial pneumonia pathology

Katzenstein AL, Zisman DA, Litzky LA, et al. Usual interstitial pneumonia histologic study of biopsy and explant specimens. Am J Surg Pathol 2002 26 1567-1577. Leslie KO. Pathology of the idiopathic interstitial pneumonias. Exp Lung Res 2005 ... 

Clinical and Pathological Features Patients with asbestosis usually are clinically similar to those with usual interstitial pneumonia and present with shortness of breath, dry cough, and Velcro rales at the lung... 

Interstitial pnemnonia is usually caused by a mechanism related to hypersensitivity to INH. Its diagnosis is mainly based on the medication history, Ixmg pathology consistent with drug-induced interstitial pneumonia and the positive result of the DLST. 

In patients with definite or probable methotrexate-induced lung injury, the predominant clinical features include shortness of breath, cough, and fever (13). Pathological examination usually shows an interstitial inflammatory cell infiltrate (sometimes granulomatous or with alveolar damage), and variable degrees of interstitial fibrosis. Unfortunately, confirmatory evidence is sometimes hard to obtain, particularly in patients with rheumatoid arthritis in whom rheumatoid interstitial lung disease can also occur. Infectious pneumonias, particularly viral or Pneumocystis jiroveci pneumonia, which resemble methotrexate pneumonitis and can occur as a result of immunosuppression, should also be carefully excluded. 

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