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Idiopathic interstitial pneumonia

Class of diffuse lung diseases affecting the pulmonary interstitium

Class of diffuse lung diseases affecting the pulmonary interstitium

FieldValue
nameIdiopathic interstitial pneumonia
synonymsNoninfectious pneumonia
imageUsual interstitial pneumonia (1).JPG
captionMicrograph of usual interstitial pneumonia (UIP). UIP is the most common pattern of idiopathic interstitial pneumonia and usually represents idiopathic pulmonary fibrosis. H&E stain. Autopsy specimen.
fieldRespirology

Idiopathic interstitial pneumonia (IIP), or noninfectious pneumonia are a class of diffuse lung diseases. These diseases typically affect the pulmonary interstitium, although some also have a component affecting the airways (for instance, cryptogenic organizing pneumonitis). There are seven recognized distinct subtypes of IIP.

Diagnosis

Classification can be complex, and the combined efforts of clinicians, radiologists, and pathologists can help in the generation of a more specific diagnosis.

Idiopathic interstitial pneumonia can be subclassified based on histologic appearance into the following patterns:

HistologyClinical Correlates
Desquamative interstitial pneumonia (DIP)DIP
Diffuse alveolar damage (DAD)ARDS, AIP, TRALI
Nonspecific interstitial pneumonia (NSIP)NSIP
Respiratory bronchiolitisRB-ILD
Usual interstitial pneumonia (UIP)CVD, IPF, drug toxicity, pneumoconiosis
Organizing pneumoniaCryptogenic organizing pneumonia
Lymphoid interstitial pneumonia (LIP)LIP

Usual interstitial pneumonia is the most common type.

Development

Table 1: Development of the (histologic) idiopathic interstitial pneumonia classification UIP=usual interstitial pneumonia; DAD=diffuse alveolar damage; NSIP=non-specific interstitial pneumonia; DIP=desquamative interstitial pneumonia; RB=respiratory bronchiolitis; BIP=bronchiolitis obliterans interstitial pneumonia; OP=organizing pneumonia; LIP=lymphoid interstitial pneumonia; LPD=lymphoproliferative disease (not considered a diffuse lung disease); GIP=giant cell interstitial pneumonia; HMF=heavy metal fibrosis, no longer grouped with diffuse lung disease

Lymphoid interstitial pneumonia was originally included in this category, then excluded, then included again.

References

References

  1. Richard K. Root. (1999). "Clinical Infectious Diseases: A Practical Approach". Oxford University Press.
  2. (2017). "Classification of idiopathic interstitial pneumonias (IIPs): radiology in focus (PDF Download Available)". ResearchGate.
  3. Nicholson AG. (November 2002). "Classification of idiopathic interstitial pneumonias: making sense of the alphabet soup". Histopathology.
  4. (October 2004). "Idiopathic interstitial pneumonia: what is the effect of a multidisciplinary approach to diagnosis?". Am. J. Respir. Crit. Care Med..
  5. (June 2006). "Classification and natural history of the idiopathic interstitial pneumonias". Proc Am Thorac Soc.
  6. Leslie KO, Wick MR. Practical Pulmonary Pathology: A Diagnostic Approach. Elsevier Inc. 2005. {{ISBN. 978-0-443-06631-3.
  7. (January 2002). "American Thoracic Society/European Respiratory Society International Multidisciplinary Consensus Classification of the Idiopathic Interstitial Pneumonias. This joint statement of the American Thoracic Society (ATS), and the European Respiratory Society (ERS) was adopted by the ATS board of directors, June 2001 and by the ERS Executive Committee, June 2001". Am. J. Respir. Crit. Care Med..
  8. (June 2006). "Histologic spectrum of idiopathic interstitial pneumonias". Proc Am Thorac Soc.
  9. (1998). "Idiopathic pulmonary fibrosis: clinical relevance of pathologic classification". Am. J. Respir. Crit. Care Med..
  10. (December 2002). "Lymphoid interstitial pneumonia: a narrative review". Chest.
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