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Inflammatory, Hypersensitivity and Immune Lung Diseases, including Parasitic Diseases.
Published in Fred W Wright, Radiology of the Chest and Related Conditions, 2022
The term 'interstitialpneumonia' implies a disease process in the lung which takes place predominantly in the supporting tissues, rather than within the alveoli. Liebow (1975) wrote 'while exudation into the alveoli occurs, this is a relatively minor component of the total response, and when healing takes place, either by restitution to the initial state (resolution), or by fibrosis, the lumina of the distal air spaces remain essentially patent'. He also felt that the term 'fibrosing alveolitis' stressed only one possible end result of earlier injury, ignored the possibility of resolution, neglected the fact that extra-alveolar interstitial tissues such as those of the bronchioles, septa and pleura are often involved, and paid no heed to the initial diversity in morphology, probable pathogenesis, natural history, and in associated laboratory and clinical manifestations, of conditions that can all terminate in interstitial fibrosis.
Radiology of Infectious Diseases and Their Potential Mimics in the Critical Care Unit
Published in Cheston B. Cunha, Burke A. Cunha, Infectious Diseases and Antimicrobial Stewardship in Critical Care Medicine, 2020
Jocelyn A. Luongo, Boris Shapiro, Orlando A. Ortiz, Douglas S. Katz
Interstitial pneumonia is characterized by cellular inflammation in the walls of the bronchioles and alveolar septa, and by inflammatory exudate or mucus partially filling the bronchiolar lumen. It commonly presents with atypical “walking” pneumonia symptoms, and reticulonodular opacities on imaging. The most common bacterial pathogen is Mycoplasma pneumoniae, but viruses, Legionella, and Pneumocystis are other common causes of interstitial pneumonia. Serology and risk factors such as immunodeficiency are sometimes the best clue to the diagnosis. Mycoplasma pneumonia has variable appearance on imaging, with bronchial wall thickening the most common feature on CT. While not specific to Mycoplasma, centrilobular or branching tree-in-bud patterns of nodules strongly suggest an acute infectious process in the distal airways on CT, as opposed to non-infectious causes of interstitial lung disease (ILD). Radiologic resolution of pneumonia often lags behind clinical improvement, and may take up to 12–14 weeks [88,89].
Pneumonitis In Acquired Immune Deficiency Syndrome (Aids)
Published in Lourdes R. Laraya-Cuasay, Walter T. Hughes, Interstitial Lung Diseases in Children, 2019
Anthony B Minnefor, James M Oleske
Failure to thrive, recurrent or persistent fevers, frequent bacterial infections, and generalized lymphadenopathy are common. Also encountered are chronic diarrhea, hepatosple-nomegaly, neurodevelopmental delay with or without seizures, thrush, and chronic parotid swelling. Kaposi’s sarcoma is uncommon.20 Interstitial pneumonia is almost always present, usually, but not always secondary to the opportunistic infections which are the hallmark of this disease.
Demystifying idiopathic interstitial pneumonia: time for more etiology-focused nomenclature in interstitial lung disease
Published in Expert Review of Respiratory Medicine, 2022
Nevins W. Todd, Sergei P. Atamas, Stella E. Hines, Irina G. Luzina, Nirav G. Shah, Edward J. Britt, Andrew J. Ghio, Jeffrey R. Galvin
Interstitial lung disease (ILD), or interstitial pneumonia, comprises a wide array of diffuse parenchymal lung diseases that encompasses close to one hundred disorders generally characterized by a combination of pulmonary inflammation and pulmonary fibrosis. The classification system, nomenclature, and acronyms used for ILD are complex, and are often confusing to general medicine physicians and pulmonary disease specialists alike. Part of the complexity is related to an incomplete understanding of several of the disease entities, whereas much of the complexity relates likely to the nomenclature used for multidisciplinary diagnoses in ILD. Confusion and complexity surrounding ILD nomenclature applies perhaps most particularly to the group of disorders termed the idiopathic interstitial pneumonias (IIPs).
Pyoderma gangrenosum with pulmonary involvement: a pulmonary special report and literature review
Published in Expert Review of Respiratory Medicine, 2022
Fanfan Xing, Kelvin Hei-Yeung Chiu, Jin Yang, Haiyan Ye, Lijun Zhang, Chenjing Liu, Kwok-Yung Yuen
Concerning further investigation among the 51 patients included in this review, 46 patients (90.2%) received a CT of the thorax for further delineation of underlying pulmonary pathology. The most common radiological findings were pulmonary infiltrates (84.8%, 39/46), followed by cavitary lesions (39.1%, 18/46), pleural effusion (13.0%, 6/46), and consolidation (10.9%, 5/46). Other radiological findings included interstitial lung disease and interstitial pneumonia. Only 27 patients (52.9%, 27/51) received bronchoscopy or open/radiological guided lung biopsy for further confirmation of the diagnosis as well as exclusion of other similar etiologies. Neutrophil infiltration or inflammation (85.2%, 23/27) was a common finding in the histopathology of the respiratory specimen, with 2 patients (11.1%, 3/27) showing pulmonary fibrosis and 5 patients (22.2%, 6/27) showing granulomatous inflammation, and with negative bacterial and fungal staining excluding the possibility of opportunistic infection in these patients.
Clinical characterization of patients with interstitial lung disease: Report from a single Canadian Center
Published in Canadian Journal of Respiratory, Critical Care, and Sleep Medicine, 2021
Charlene D. Fell, Gillian C. Goobie, Chelsea A. Ford-Sahibzada, Kerri A. Johannson
Patient diagnoses were established during bi-weekly ILD multidisciplinary team (MDT) meetings, during which cases were reviewed by respirologists, thoracic radiologists and pulmonary pathologists with expertise in ILD. Diagnoses were based on contemporaneous international 2011 IPF22 and 2002 idiopathic interstitial pneumonia (IIP)23 guidelines. Because patients were enrolled into the study prior to the publication of the updated IPF and IIP guideline statements; all clinical data and diagnoses were reviewed at the time of data analysis to ensure diagnostic classification consistent with the most recent 2018 IPF24 and 2013 IIP25 guidelines. If a consensus diagnosis could not be reached by the MDT, the patient’s ILD was labeled “unclassifiable” and a working diagnosis or differential diagnosis was noted. The date of diagnosis was established as the date on which all of the necessary information was available to arrive at a diagnosis; usually, this was the date of the first CT chest or surgical lung biopsy (if performed). In many cases, the date of diagnosis preceded the patient’s first visit to the ILD clinic by several months.