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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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Related in: MedlinePlus

Honeycomb remodelling. (A) Large, often stacked, cystic spaces seen in whole-lung sections are referred to as “honeycomb cysts”. (B) These are often recapitulated (or preceded) at the microscopic level, where the process is referred to as “microscopic honeycombing”. (A) Gross image; (B) H&E stain, 1× original magnification.
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CPT-62-05-0387-f08: Honeycomb remodelling. (A) Large, often stacked, cystic spaces seen in whole-lung sections are referred to as “honeycomb cysts”. (B) These are often recapitulated (or preceded) at the microscopic level, where the process is referred to as “microscopic honeycombing”. (A) Gross image; (B) H&E stain, 1× original magnification.

Mentions: Interstitial lung fibrosis is often accompanied by permanent and irreversible alteration of lung architecture. Pattern 2 (fibrosis) tends to carry great prognostic significance for the patient and is only superseded in importance by pattern 1 (acute lung injury). Different patterns of fibrosis probably derive from different injury mechanisms, carry different prognostic implications, and one day may influence targeted treatments. Large, often stacked, cystic spaces that can be seen on CT scans of the chest and in whole-lung sections and referred to as “honeycomb cysts” are often recapitulated (or preceded) at the microscopic level, where the process is referred to as “microscopic honeycombing” (fig 8). A general morphological approach to diffuse lung fibrosis should include an assessment of the distribution and character of the fibrotic or fibroblastic reaction, the degree and extent of mature interstitial scarring, and the presence or absence of microscopic honeycomb remodelling.


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

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

Honeycomb remodelling. (A) Large, often stacked, cystic spaces seen in whole-lung sections are referred to as “honeycomb cysts”. (B) These are often recapitulated (or preceded) at the microscopic level, where the process is referred to as “microscopic honeycombing”. (A) Gross image; (B) H&E stain, 1× original magnification.
© Copyright Policy - openaccess
Related In: Results  -  Collection

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

CPT-62-05-0387-f08: Honeycomb remodelling. (A) Large, often stacked, cystic spaces seen in whole-lung sections are referred to as “honeycomb cysts”. (B) These are often recapitulated (or preceded) at the microscopic level, where the process is referred to as “microscopic honeycombing”. (A) Gross image; (B) H&E stain, 1× original magnification.
Mentions: Interstitial lung fibrosis is often accompanied by permanent and irreversible alteration of lung architecture. Pattern 2 (fibrosis) tends to carry great prognostic significance for the patient and is only superseded in importance by pattern 1 (acute lung injury). Different patterns of fibrosis probably derive from different injury mechanisms, carry different prognostic implications, and one day may influence targeted treatments. Large, often stacked, cystic spaces that can be seen on CT scans of the chest and in whole-lung sections and referred to as “honeycomb cysts” are often recapitulated (or preceded) at the microscopic level, where the process is referred to as “microscopic honeycombing” (fig 8). A general morphological approach to diffuse lung fibrosis should include an assessment of the distribution and character of the fibrotic or fibroblastic reaction, the degree and extent of mature interstitial scarring, and the presence or absence of microscopic honeycomb remodelling.

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