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The Proceedings of the American Thoracic Society 3:322-329 (2006)
© 2006 The American Thoracic Society

Histologic Spectrum of Idiopathic Interstitial Pneumonias

Daniel W. Visscher and Jeffrey L. Myers

Division of Anatomic Pathology, Mayo Clinic, Rochester, Minnesota; and Division of Anatomic Pathology, University of Michigan, Ann Arbor, Michigan

Correspondence and requests for reprints should be addressed to Daniel W. Visscher, M.D., Division of Anatomic Pathology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905. E-mail: visscher.daniel{at}mayo.edu

ABSTRACT

Histopathologic classification plays a key role in separating multiple forms of idiopathic interstitial pneumonia into clinically meaningful categories with important differences in natural history, prognosis, and treatment. Microscopic criteria in diagnosis of these entities include the pattern and microanatomic distribution of inflammation, fibroblast proliferation, collagen deposition, and architectural remodeling. Usual interstitial pneumonia (UIP) defines idiopathic pulmonary fibrosis and is the most common of the idiopathic interstitial pneumonias. UIP has distinctive morphologic features that allow precise diagnosis in classical cases. Other forms of idiopathic interstitial pneumonia include desquamative interstitial pneumonia, respiratory bronchiolitis–associated interstitial lung disease, acute interstitial pneumonia, and nonspecific interstitial pneumonia. These latter categories differ from UIP in that the histopathologic findings do not, by themselves, allow specific diagnosis in most cases and require careful correlation with clinical and radiologic findings.

Key Words: idiopathic interstitial pneumonias • idiopathic pulmonary fibrosis • nonspecific interstitial pneumonia • usual interstitial pneumonia




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