Type:
Educational Exhibit
Keywords:
Lung, CT, Diagnostic procedure, Education, Inflammation, Occupational / Environmental hazards
Authors:
M. Mangi, Y. Lam, W. Lim
DOI:
10.26044/ranzcr2022/R-0042
Background
Interstitial lung disease (ILD) refers to a wide range of conditions that cause varying degrees of inflammation and fibrosis of pulmonary parenchyma [1]. ILD may be broadly subdivided by aetiology. Idiopathic interstitial pneumonia (IIP) encompasses a group of ILDs of unknown cause. ILD can be associated with connective tissue diseases such as rheumatoid arthritis and granulomatous diseases such as sarcoidosis. Exposure-related ILD includes asbestosis, silicosis and hypersensitivity pneumonitis.
The diagnosis of ILD requires a multidisciplinary approach. Supportive features include characteristic symptoms and signs such as dyspnoea and clubbing, a history of environmental exposure or systemic disease, and pulmonary function testing showing a restrictive pattern [2,3]. Imaging, particularly high-resolution CT (HRCT), plays a crucial role in the multidisciplinary assessment and may change the initial diagnosis in 20% of cases and alter the clinical impression in 51% [4].
The single most common ILD is idiopathic pulmonary fibrosis (IPF), a type of IIP, which is characterised by progressive fibrosis and has a poor overall prognosis. IPF typically occurs in elderly males and is associated with smoking. Before considering the diagnosis of IPF, ILDs associated with environmental exposures and systemic diseases should be excluded based on history and serological evidence [1].