aka alveolar macrophage pneumonia
a less angr brother to RB ILD
- Inflammatory
- pigmented intra-alveolar macrophages and giant sells in the alveioli
- Cause
- Mostly smokers
- 10-40% are non smokers
- inhalational toxic
- druga
- viral illness
- autoimmune diseases
- results
- Structural
- Path
- alveoli
- architecture maintained
- macrophages
- Interstitium
- mild chronic inflammation
- CXR
- CT
- widespread
- patchy ground glass
- lower lobes (70%)
- bilateral
- relatively symmetrical
- peripheral (60%)
- honeycomb can happen
- Functional
Buzz
- DIP
- aberrances
- DIP imagine somebody dipping a rag of into cigarette smoke and dabbing it in the lower lung zones smoke
Lungs
- Desquamative –
- squams = misnomer
- infiltrates represent alveolar filling with pigmented macrophages. alveoli
interstitial mucosa/submucosa vessels
pneumonia = “inflammation of the lungs,”
desquamate – fill the alveoli
Small Airways
Inflammation
Secondary Lobule
Alveoli
Inhalation ? Lower Lobes
Smokers but
- Desquamative Interstitial Pneumonia (DIP) is a rare form of idiopathic interstitial pneumonia (IIP).
- Cause
- Smokers
- also related to marijuana smoke inhalation,
- infections such as HIV,
- toxins, or
- occupational exposure (eg, to asbestos)
- Results in
- infiltrates represent alveolar filling with pigmented macrophages. alveoli
-
- Diagnosis
- Clinical
- Cougn Dyspnea
- DX difficult on
- clinical and radiological features alone
- requires a (surgical) lung biopsy
- Imaging
- bilateral ground-glass opacities with
- lower lobe predominance (92%).
- irregular reticulation,
- traction bronchiectasis and
- cysts.
- sometimes
- ground-glass opacities
- architectural distortion,
- traction bronchiectasis and
- honeycombing.
- Path
- pigmented macrophages within
- most of the distal airspace of the lung
- Histologically,
- DIP is similar to RB-ILD,
- DIP and RB-ILD are a spectrum
- differing in compartments involved
-
- DIP not bronchiolocentric.
- hyperplasia of the alveolar type II cells
- distribution pattern more homogeneous a
- mild peribronchial fibrosis
-
Radiology Buzz
References and Links
Attili, A.K etal Smoking-related Interstitial Lung Disease: Radiologic-Clinical-Pathologic Correlation RadioGraphics Vol. 28, No. 5
Gupta et al Diffuse Cystic Lung Disease: Part I American Journal of Respiratory and Critical Care Medicine 191(12) April 2015
INTERSTITIAL PNEUMONIA , IP
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