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Idiopathic Interstitial Pneumonias

 Andrew Churg MD
  15th-Oct-2013
Description: Idiopathic Interstitial Pneumonias - General Comments About ILD, Consultation with the radiologist is extremely valuable in making a diagnosis of ILD, Consultation with the clinician is usually helpful--it generally limits the differential diagnosis, It’s very difficult to diagnose ILD without clinical and radiologic information! Some cases of ILD defy exact classification–consider collagen vascular diseases and drug reactions in this situation. The ―Idiopathi c Interstitial Pneumonia Problem, There are a number of entities referred to as idiopathic interstitial pneumonias, Some are not idiopathic (RBILD, DIP), Some are not really interstitial pneumonias (AIP), The formal classifications tend to hide the real prognostic features, The term ―idiopathic interstitial pneumonia is actually useless. General Morphologic Approach to Chronic Interstitial Lung Disease, Is this is a malignancy; eg lymphangitic ca, lymphoma?, Is this an infection (PCP, CMV) ?, Is this an interstitial lung disease with a defined specific feature; eg, sarcoid?, Is this a form of idiopathic chronic interstitial pneumonia?, Is this a localized artifact (scar, edge of another lesion, etc)?–ILD are diffuse conditions by definition, Is this a drug reaction or a collagen vascular disease. Clinical Features of UIP, Typically presents with a history of insidious onset of shortness of breath, Shortness of breath increases over a period of many months to years, Velcro rales on inspiration, Clubbing in as many as 50% of cases. When dealing with a putative case of idiopathic interstitial pnemonia, separation of UIP from everything else is the most important role of pathologic diagnosis.
Views: 2851
Domain: Medical
Category: Therapy
Contents:
The Idiopathic Interstitial
Pneumonias
Andrew Churg, MD
Departments of Pathology
University of British Columbia
and Vancouver General Hospital
Vancouver, BC, Canada
achurg@mail.ubc.ca

General Comments About ILD
• Consultation with the radiologist is extremely
valuable in making a diagnosis of ILD
• Consultation with the clinician is usually helpful--it
generally limits the differential ... See more

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