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My approach to interstitial lung disease using clinical, radiological and histopathological patterns.

Leslie KO - J. Clin. Pathol. (2009)

Bottom Line: The complex world of interstitial lung disease presents nearly insurmountable challenges to the general surgical pathologist faced with a lung biopsy in this setting.The pathology is often inflammatory and always requires clinical and radiological context for a relevant and clinically useful histopathological diagnosis.A pattern-based histopathological approach to interstitial lung disease provides a "map" for the general pathologist to navigate this area successfully, especially so when used with aid of the clinical and radiological patterns of presentation.

View Article: PubMed Central - PubMed

Affiliation: Division of Anatomic Pathology, Mayo Clinic Arizona, Scottsdale, AZ 85259, USA. leslie.kevin@mayo.edu

ABSTRACT
The complex world of interstitial lung disease presents nearly insurmountable challenges to the general surgical pathologist faced with a lung biopsy in this setting. The pathology is often inflammatory and always requires clinical and radiological context for a relevant and clinically useful histopathological diagnosis. A pattern-based histopathological approach to interstitial lung disease provides a "map" for the general pathologist to navigate this area successfully, especially so when used with aid of the clinical and radiological patterns of presentation.

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Acute injury with necrosis. Necrosis (N) is a harbinger of infection in the context of pattern 1 and an acutely ill patient. Infection always leads the differential diagnosis in this situation, even if special stains are negative. H&E stain, 100× original magnification.
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CPT-62-05-0387-f03: Acute injury with necrosis. Necrosis (N) is a harbinger of infection in the context of pattern 1 and an acutely ill patient. Infection always leads the differential diagnosis in this situation, even if special stains are negative. H&E stain, 100× original magnification.

Mentions: Tissue necrosis raises a differential diagnosis of infection, infarction, neoplasm and Wegener granulomatosis (and similar conditions such as so-called necrotising sarcoidosis and sometimes Churg–Strauss syndrome). When necrosis is present (fig 3) in the acutely ill patient, infection leads the differential diagnosis, even if special stains are negative. Conversely the lack of necrosis in a biopsy specimen from an acutely ill patient with normal immunity virtually eliminates clinically significant infection as the primary aetiology in my experience.


My approach to interstitial lung disease using clinical, radiological and histopathological patterns.

Leslie KO - J. Clin. Pathol. (2009)

Acute injury with necrosis. Necrosis (N) is a harbinger of infection in the context of pattern 1 and an acutely ill patient. Infection always leads the differential diagnosis in this situation, even if special stains are negative. H&E stain, 100× original magnification.
© Copyright Policy - openaccess
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2668105&req=5

CPT-62-05-0387-f03: Acute injury with necrosis. Necrosis (N) is a harbinger of infection in the context of pattern 1 and an acutely ill patient. Infection always leads the differential diagnosis in this situation, even if special stains are negative. H&E stain, 100× original magnification.
Mentions: Tissue necrosis raises a differential diagnosis of infection, infarction, neoplasm and Wegener granulomatosis (and similar conditions such as so-called necrotising sarcoidosis and sometimes Churg–Strauss syndrome). When necrosis is present (fig 3) in the acutely ill patient, infection leads the differential diagnosis, even if special stains are negative. Conversely the lack of necrosis in a biopsy specimen from an acutely ill patient with normal immunity virtually eliminates clinically significant infection as the primary aetiology in my experience.

Bottom Line: The complex world of interstitial lung disease presents nearly insurmountable challenges to the general surgical pathologist faced with a lung biopsy in this setting.The pathology is often inflammatory and always requires clinical and radiological context for a relevant and clinically useful histopathological diagnosis.A pattern-based histopathological approach to interstitial lung disease provides a "map" for the general pathologist to navigate this area successfully, especially so when used with aid of the clinical and radiological patterns of presentation.

View Article: PubMed Central - PubMed

Affiliation: Division of Anatomic Pathology, Mayo Clinic Arizona, Scottsdale, AZ 85259, USA. leslie.kevin@mayo.edu

ABSTRACT
The complex world of interstitial lung disease presents nearly insurmountable challenges to the general surgical pathologist faced with a lung biopsy in this setting. The pathology is often inflammatory and always requires clinical and radiological context for a relevant and clinically useful histopathological diagnosis. A pattern-based histopathological approach to interstitial lung disease provides a "map" for the general pathologist to navigate this area successfully, especially so when used with aid of the clinical and radiological patterns of presentation.

Show MeSH
Related in: MedlinePlus