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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

Airway-centred fibrosis. Fibrosis around bronchioles is typically a manifestation of inhalational or aspiration injury to the lungs. H&E stain, 15× original magnification.
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CPT-62-05-0387-f13: Airway-centred fibrosis. Fibrosis around bronchioles is typically a manifestation of inhalational or aspiration injury to the lungs. H&E stain, 15× original magnification.

Mentions: When scarring occurs diffusely around bronchioles (fig 13), the differential diagnosis generally is limited to inhalation (eg, hypersensitivity pneumonitis)21 and aspiration-associated injury and certain rheumatic or immune-mediated systemic conditions (eg, rheumatoid arthritis, Sjogren syndrome). An idiopathic form has been described.22 23 In some biopsy samples, the airway-centred nature of the process may be difficult to discern, especially when fibrosis is advanced and/or the sample is small. The HRCT distribution may be helpful, as UIP and the autoimmune diseases tend to involve the periphery and lower lung zones, whereas diffuse inhalational injuries tend to have a more mid-zone and upper lung zone distribution (at least relatively early in the process).


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

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

Airway-centred fibrosis. Fibrosis around bronchioles is typically a manifestation of inhalational or aspiration injury to the lungs. H&E stain, 15× original magnification.
© Copyright Policy - openaccess
Related In: Results  -  Collection

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

CPT-62-05-0387-f13: Airway-centred fibrosis. Fibrosis around bronchioles is typically a manifestation of inhalational or aspiration injury to the lungs. H&E stain, 15× original magnification.
Mentions: When scarring occurs diffusely around bronchioles (fig 13), the differential diagnosis generally is limited to inhalation (eg, hypersensitivity pneumonitis)21 and aspiration-associated injury and certain rheumatic or immune-mediated systemic conditions (eg, rheumatoid arthritis, Sjogren syndrome). An idiopathic form has been described.22 23 In some biopsy samples, the airway-centred nature of the process may be difficult to discern, especially when fibrosis is advanced and/or the sample is small. The HRCT distribution may be helpful, as UIP and the autoimmune diseases tend to involve the periphery and lower lung zones, whereas diffuse inhalational injuries tend to have a more mid-zone and upper lung zone distribution (at least relatively early in the process).

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