Learning objectives
The aim of this educational exhibit is to:
Describe the usual interstitial pneumoniapattern;
Review the main conditions withusual interstitial pneumoniapattern;
Discuss the differential diagnosis and treatment possibilities of those conditions.
Background
Interstitial lung diseases (ILDs) are a heterogeneous group of nonneoplastic diffuse parenchymal lung diseases that result from damage to the lungs by varying combinations of inflammation and fibrosis.
There are more than 300 conditions that are included in the total number of ILDs,
which can be classified into four main groups (Fig. 1).
Usual interstitial pneumonia is a characteristic patternof idiopathic pulmonary fibrosis (IPF),
whichis the most frequent of the ILDs.
However,
UIP is not synonymous with IPF.
UIP pattern can also be caused by...
Findings and procedure details
UIP pattern
On HRCT images UIP pattern is defined by these specific features:
Honeycombing.On CT honeycombing is defined as subpleurally located,
clustered,
thick-walled,
cystic spaces of similar diameters between 3–10 mm (occasionally up to 25 mm).
Usually honeycombing consist of several stacked layers of cysts,
however,
for diagnosis a single subpleural layer of 2-3 contiguous cysts is adequate.Honeycombing is one of the key findings of this pattern as it is an indicator of end-stage pulmonary fibrosis.Traction bronchiectasis,
large cysts,
paraseptal or centrilobular emphysema may complicate...
Conclusion
UIP pattern can be observed in many conditions.
Additional radiological and clinical information is essential for the correct interpretation of UIP pattern and the choice of optimal treatment.
References
References
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Dellaripa PF.Interstitial lung disease in the connective tissue diseases; a paradigm shift in diagnosis and treatment.Clin Immunol.
2018 Jan;186:71-73.
doi:10.1016/j.clim.2017.09.015.
2.
Aburto M,
Herráez I,
Iturbe D,
Jiménez-Romero A.
Diagnosis of Idiopathic Pulmonary Fibrosis: Differential Diagnosis.Med Sci (Basel).
2018;6(3):73.
Published 2018 Sep 4.
doi:10.3390/medsci6030073
3.Torres PPTES,
Rabahi MF,
Moreira MAC,
Meirelles GSP,
Marchiori E.
Usual interstitial pneumonia: typical,
possible,
and "inconsistent" patterns.J Bras Pneumol.
2017;43(5):393-398.
4.
Pereira CA,
Gimenez A,
Kuranishi L,
Storrer K.
Chronic hypersensitivity pneumonitis.J Asthma Allergy.
2016;9:171-181.
Published 2016 Sep...