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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

Pulmonary alveolar proteinosis (PAP). All of the diagnostic features of PAP are identifiable in this image: alveolar exudates with an eosinophilic granular appearance, scattered larger inclusions with more intense eosin staining, and slight retraction effect at the periphery of the alveolus. H&E stain, 40× original magnification.
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CPT-62-05-0387-f23: Pulmonary alveolar proteinosis (PAP). All of the diagnostic features of PAP are identifiable in this image: alveolar exudates with an eosinophilic granular appearance, scattered larger inclusions with more intense eosin staining, and slight retraction effect at the periphery of the alveolus. H&E stain, 40× original magnification.

Mentions: The prototype of this pattern is pulmonary alveolar proteinosis (PAP). This distinctive disease results in dense granular eosinophilic material filling adjacent alveoli. PAP can be focal or segmental in distribution. Cholesterol clefts and hyaline globules are typically present in the granular infiltrates, and a rim of retraction often separates the infiltrates from adjacent alveolar walls (fig 23). The disease occurs commonly as a primary idiopathic form, but may also be seen as a secondary phenomenon in the settings of occupational disease (especially dust-related), drug-induced injury, haematological diseases and in many settings of immunodeficiency.35 36 The granularity of the alveolar material helps differentiate PAP from other alveolar filling processes (such as pulmonary oedema and Pneumocystis infection).


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

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

Pulmonary alveolar proteinosis (PAP). All of the diagnostic features of PAP are identifiable in this image: alveolar exudates with an eosinophilic granular appearance, scattered larger inclusions with more intense eosin staining, and slight retraction effect at the periphery of the alveolus. H&E stain, 40× original magnification.
© Copyright Policy - openaccess
Related In: Results  -  Collection

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

CPT-62-05-0387-f23: Pulmonary alveolar proteinosis (PAP). All of the diagnostic features of PAP are identifiable in this image: alveolar exudates with an eosinophilic granular appearance, scattered larger inclusions with more intense eosin staining, and slight retraction effect at the periphery of the alveolus. H&E stain, 40× original magnification.
Mentions: The prototype of this pattern is pulmonary alveolar proteinosis (PAP). This distinctive disease results in dense granular eosinophilic material filling adjacent alveoli. PAP can be focal or segmental in distribution. Cholesterol clefts and hyaline globules are typically present in the granular infiltrates, and a rim of retraction often separates the infiltrates from adjacent alveolar walls (fig 23). The disease occurs commonly as a primary idiopathic form, but may also be seen as a secondary phenomenon in the settings of occupational disease (especially dust-related), drug-induced injury, haematological diseases and in many settings of immunodeficiency.35 36 The granularity of the alveolar material helps differentiate PAP from other alveolar filling processes (such as pulmonary oedema and Pneumocystis infection).

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