NSIP vs UIP Pathology

Pathology Outlines - Nonspecific interstitial pneumoni

Discordant features may be seen (UIP on one biopsy, NSIP on another) Behaves as UIP; Multiple biopsies are recommended, if possible; The following must be ruled out in every case. Collagen vascular disease Typically has more inflammation and follicles; Typically less fibroplasia and honeycombing; Drug reaction; Infectio In contrast, UIP is associated with extensive fibrosis which is temporally inhomogeneous (i.e. various lesions are of different ages). NSIP is a very inhomogeneous group. NSIP ranges from type I which is a cellular pattern seen as ground glass opacity on HRCT to type IV with a fibrotic pattern, which may be indistinguishable from UIP NSIP: Das Krankheitsbild wurde erst kürzlich aus dem der UIP herausgelöst. 70% der Patienten mit Kollagenkrankheiten haben NSIP-ähnliche histologische Zeichen. Vor der Diagnosestellung müssen also übergeordnete Systemerkrankungen ausgeschlossen werden. Möglicherweise sind NSIP und UIP frühe bzw. späte Stadien der gleichen Krankheit Das typische histologische Muster der IPF wird als Usual Interstitial Pneumonia (UIP, gewöhnliche interstitielle Pneumonie) bezeichnet und ist charakterisiert durch eine fleckenförmige Fibrose sowie eine honigwabenartige Struktur der Lunge. Das Muster der UIP ist charakteristisch, aber nicht spezifisch für die IPF und kommt auch bei anderen interstitiellen Lungenerkrankungen vor. Im Röntgenbild zeigt sich in fortgeschrittenen Stadien der Erkrankung eine basale retikuläre. UIP/IPF - gross specimen Small, firm, fibrosed lung seen in advanced disease 32. UIP/IPF - gross specimen White tissue represents interstitial fibrosis 33. UIP/IPF - histologic section Spatial heterogeneity: fibrosis with interspersed normal lung 34. {Extrapulmonary manifestations 35. NSIP 36

Le type histologique est dénommé NSIP. Il existe deux sous-groupes de la NSIP, un sous-type cellulaire et un sous-type fibrotique. Dans le premier, le tableau histologique est dominé par des cellules inflammatoires, dans le second se distinguent en plus des zones marquées de fibrose. Le cliché radiographique est riche en variantes, comme le type histologique. À côté d'ombres laiteuses. The most compelling distinction between NSIP and UIP was related to outcome: NSIP had a significantly better prognosis than UIP. Treatment was similar in both groups, although corticosteroids with or without immunosuppres-sants were used more frequently in patients with NSIP (61.3%) than patients with UIP (46.9%). Nearly 75% o § 72% chronic HP = UIP-like; § three BIP/F; § 16% F-NSIP § Only 2 UIP-like cases could not be morphologically distinguished from idiopathic UIP. § Survival for patients with no fibrosis = 22.4 years § Fibrotic NSIP = 2.1 years; § UIP-like pattern = 2.8 year

Community | Participation Program for Pulmonary Fibrosis

Differentiating Between Nonspecific and Usual Interstitial

  1. In this study of patients with histologically well defined UIP and NSIP we found that: (1) patients with an HRCT pattern of UIP are likely to have a histopathological pattern of UIP, but patients with an HRCT pattern other than UIP may have either a histological pattern of UIP or NSIP on the surgical lung biopsy specimen; (2) HRCT features add prognostic information to the histological diagnosis of UIP; survival was worse if patients with histological UIP had an HRCT picture felt.
  2. al centres or pro
  3. At histopathologic analysis, connective tissue disease-related interstitial lung diseases (CTD-ILDs) are diverse and include nonspecific interstitial pneumonia (NSIP), usual interstitial pneumonia (UIP), organizing pneumonia (OP), apical fibrosis, diffuse alveolar damage (DAD), and lymphoid interstitial pneumonia (LIP). Even though proportions of ILDs vary, NSIP pattern accounts for a large proportion, especially in PSS, DM/PM and MCTD, followed by UIP pattern. Evidence has been published.
  4. The idiopathic interstitial pneumonias (IIPs) are a heterogeneous group of disorders that include usual interstitial pneumonia (UIP), nonspecific interstitial pneumonia (NSIP), respiratory bronchiolitis-interstitial lung disease (RB-ILD), acute interstitial pneumonia (AIP), cryptogenic organizing pneumonia (COP), desquamative interstitial pneumonia (DIP), and lymphoid interstitial pneumonia (LIP)
  5. In patients with either UIP or NSIP from whom more than one site is biopsied, about one in four will show discordant results, meaning that one piece of tissue is diagnostic of UIP whereas another shows NSIP (47, 49). The presence of UIP in any piece of tissue is the single most important predictor of outcome in this circumstance, attesting to the specificity of UIP as a clinicopathologic entity. Histopathologic features that are most helpful in distinguishing UIP includ
  6. ant features associated with NSIP on HRCT are ground glass opacity and reticulation with a peribronchovascular distribution. 3

interstitial pneumonia, LIP = lymphoid interstitial pneumonia, NSIP = nonspecific interstitial pneumonia, RB-ILD = respiratory bronchiolitis-inter-stitial lung disease, UIP = usual interstitial pneumonia RadioGraphics 2009; 29:73-87 • Published online 10.1148/rg.291085096 • Content Codes NSIP: nicht spezifische interstitielle pneumonie. NSIP: nicht spezifische interstitielle pneumonie. Für PatientInnen . Über uns Universitätsspital Bern, Dr. Jean-Claude Pache, Abteilung für Pathologie, Universitätsspital Genf, NSIP - SIOLD.pdf. Adobe Acrobat Dokument 316.4 KB. Download. Lungenfibrose Forum Austria T: 0699 11 50 64 12 F : Kontaktformular M: office@lungenfibroseforum.at. Usual interstitial pneumonia. Usual interstitial pneumonia ( UIP) is a histopathologic and radiologic pattern of interstitial lung disease, which is the hallmark pattern for idiopathic pulmonary fibrosis (IPF) . On imaging, usual interstitial pneumonia usually presents with a lung volume loss and a craniocaudal gradient of peripheral septal.

Table 1 from Idiopathic Interstitial Pneumonias (IIPs

One vimentin subtype was upregulated in UIP, while another one was downregulated in NSIP (vs. control). These different characteristics were partially supported by the results of Western blot analysis. Our immunohistochemistry revealed vimentin expression within fibroblasts (a) in fibroblastic foci in UIP and (b) in fibrotic alveolar walls in NSIP. Differences in vimentin subtypes may provide useful biomarkers for separating NSIP from UIP, alongside differences in histological characteristics Chronically fibrosing (UIP and NSIP) Smoking related (DIP and RB-ILD) Acutely presenting (COP and AIP) This approach may better assist the clinician in terms of recognition and work-up of initially undifferentiated presenting disease. While any of the eight may appear independently as primary or idiopathic disease, many are involved in the progressive lung injury associated with chronic organic or inorganic exposures, drug toxicity, and autoimmune disease. A combined approach of not only. High-resolution computed tomography (HRCT) chest findings associated with MPA in PF patients demonstrate a high frequency of usual interstitial pneumonia (UIP), fibrotic-nonspecific interstitial pneumonia (F-NSIP), and combined PF and emphysema (CPFE) pattern with honeycombing, traction bronchiectasis, ground-glass opacity, and emphysema. In most of these cases, the histologic pattern of PF has been classified as UIP and/or fibrotic NSIP. In addition, a high incidence of histological. Churg et al 27 reported that a fibrotic NSIP picture is less common than a UIP-like picture (4 of 25 cases [16%] versus 18 of 25 cases [72%]), but Ohtani et al 33 found about equal numbers (8 cases of fibrotic NSIP versus 11 cases UIP-like) and Wang et al 32 reported the opposite pattern (22/39 NSIP versus 7/39 UIP-like) 1 Definition. Die idiopathische Lungenfibrose, kurz IPF, ist eine Sonderform der Lungenfibrose.Es handelt sich um eine chronisch fibrosierende Erkrankung der Lunge mit langsamer Progredienz.. Verläuft die Erkrankung akut, spricht man von einer akuten interstitiellen Pneumonie (Hamman-Rich-Syndrom).. ICD10-Code: J84.1 ; 2 Epidemiologie. Die Erkrankung ist selten

Organizing pneumonia is caused by inflammation 10 and may be idiopathic in nature, termed cryptogenic organizing pneumonia, or may occur secondary to infection, collagen vascular disease, or drug toxicity. 35 Organizing pneumonia is characterized by the presence of consolidation and may also show features of fibrosis reminiscent of NSIP. 10 Interstitial lung diseases are a heterogeneous group of disorders characterized by the inflammation and fibrosis of lung parenchyma, especially the pulmonary connective tissue in the alveolar walls. It may be idiopathic (e.g., idiopathic pulmonary fibrosis) or secondary to connective tissue diseases, medications, malignancies, occupational. Not only was there the migration between NSIP-C and NSIP-F, but also the morphological appearance of NSIP and UIP coexisted in upper lobe. For example, formation of cystic fibrous gas cavity with fibroblast foci was hard to be differentiated from honeycomb, the latter and fibroblast foci were the morphological features of UIP. Besides, pathological appearance of middle and lower lobes showed. Cases confirmed as IPF/UIP by central pathology panel 64 36 28 25% of cases rejected as not UIP by reference pathologists 50% F-NSIP 23% EAA (8% in total) BUILD 1 drug trial Pathologic patterns and survival in chronic HP. Churg et al. AJSP 2009;33:1765 Histopathologicpattern and clinical features of rheumatoid arthritis-associated interstitial lung disease Lee HK et al. Chest 2005;127:2019-27.

Morphologically OP (n = 3) and NSIP-like (n = 2), UIP-like (n = 2) or DAD-like (n = 1) patterns were seen. OP was found in IP with concomitant giant bullous emphysema, colitis ulcerosa and alcoholic cirrhosis. NSIP-like histology was seen in asbestosis and bone marrow transplantation, UIP-like changes in Jo-1 syndrome and after ACE inhibitor therapy. A DAD-like pattern was found in a patient. Prognosis of Fibrotic IPs (NSIP and UIP): Idiopathic vs CTD-Related (Park JH et. Al AJRCCM 2007; 175: 705) IIP 269 pts (203 UIP, 66 NSIP) CTD-IP 93 pts (36 UIP, 57 NSIP) p=0.001 IPF/UIP IPF vs. CTD-UIP The 14 patients excluded by the pathology panel were: three with UIP, two with honeycombing (not UIP), two with BOOP, one with fibrotic NSIP associated with Sjögren's syndrome, one with eosinophilic granuloma, one with eosinophilic pneumonia, one with hypersensitivity pneumo-nitis and bron-chiectasis, one with organizing DAD, one with pulmonary veno-occlusive disease and one with res-piratory. Lower zone predominance: UIP, NSIP, DIP. Centrilobular distribution: Hypersensitivity pneumonitis, Respiratory bronchiolitis; Broncho-alveolar cell carcinoma with ground-glass opacity and consolidation . The ground glass pattern itself is rather unspecific. Not suprisingly, there is a big overlap in the causes of ground-glass opacity and consolidation and some diseases may present with both.

Comparison of Usual Interstitial Pneumonia and Nonspecific

  1. A bronchoscopy with bronchoalveolar lavage and transbronchial biopsy revealed 30% lymphocytes and nondiagnostic pathology. An open lung biopsy revealed fibrotic nonspecific interstitial pneumonia (NSIP). Prednisone was started with some initial symptomatic improvement. His symptoms, however, progressed again despite continued prednisone, and he was referred to our institution for a second.
  2. The lung pathology confirmed a diagnosis of nonspecific interstitial pneumonia. Nonspecific interstitial pneumonia (NSIP) represents a subtype of idiopathic interstitial pneumonia (IIP) with histologic features distinct from other IIPs, including varying degrees of cellular interstitial infiltrate (usually of mononuclear inflammatory cells) and interstitial fibrosis
  3. The CT signs may reflect the natural history of the NSIP to UIP progression. For example, the exuberant honeycombing sign may arise from the homogeneous nature of NSIP as opposed to the more temporal and spatially heterogeneous nature of UIP in IPF. The affected portions of lung in NSIP may worsen uniformly over time, giving rise to the florid honeycombing pattern of end-stage disease. The.

Non-specific interstitial pneumonia Radiology Reference

  1. UIP. It should be considered in all adult patients with unexplained chronic exertional dyspnea,cough,bibasilarinspiratorycrackles, and/or digital clubbing that occur without constitutional or other symptoms that suggest a multisystem disease. The incidence of IPF increases with older age, with presentation typically consisting of insidious onset of dyspnea in the sixth and seventh decades (8.
  2. Interestingly, NSIP pathology seems to be much more consistent regarding its radiological expression . The key point is that an inconsistent with UIP radiological pattern does not rule out the diagnosis of IPF, but mandates histological confirmation regardless the pretest probability of the patient
  3. Residual HP VS UIP VS Fibrotic NSIP HP UIP NSIP upper lobe lower lobe lower lobe airway- centered subpleural airway- centered 33. Granulomatous infections Special stains for microorganisms in all biopsies with granulomas Culture correlation 34
  4. UIP vs NSIP is the major clinical problem- surgical biopsy needed for diagnosis . NONDIAGNOSTI Tx's Abnormal but not diagnostic From a case of PLCH From a case of COP A list of pathologic findings (ie. a descriptive diagnosis) is not a definitive clinicopathologic diagnosis. TBBx IN ILD Author Diagnostic Bx Comment Anderson 1978 N=939 (rev'd by Churg) 31% Nonspec- 44% Normal/Inad- 25%.
  5. Discordant UIP (separate UIP and NSIP patterns in different samples of the same patient) has been reported to have outcomes similar to concordant UIP (same UIP pattern in different samples) and significantly worse when compared with concordant NSIP in SLBs [6, 9]. Hence, we conferred a diagnosis of UIP in SLBs if UIP pattern was seen in any of the sampled lobes. In 13 of the 217 cases (5.9%.
  6. In idiopathic pulmonary fibrosis (IPF) and usual interstitial pneumonia (UIP) (Figs. 17.1 and 17.2), cystic structures are mainly composed of true HC cysts in the peripheral portion of the lungs, while most cystic structures in patients with nonspecific interstitial pneumonia (NSIP) (Fig. 17.3) seem to be tangential views of TB . Of course, even in patients with NSIP, main cysts of HC are the.
  7. Much of my notes are derived from the Osler Pathology Review videos/notes, from CAP PIP Case studies, ExpertPath, LibrePathology and Pathology Outlines. As I have limited time to maintain this website, twitter and study for the boards, I am going to simply allow read-only access to my original study document. Please note that the document is a running draft and may change significantly from.

Usual Interstitial Pneumonia - Surgical Pathology Criteria

These five patients included all three patients with UIP, one patient with NSIP, and one patient with diffuse interstitial amyloidosis. The remaining four patients (22%) maintained stable pulmonary function during the follow-up period and included both patients with primary pulmonary lymphoma, one patient with LIP, and one patient with NSIP Differentiating fibrosing NSIP from UIP is perhaps the greatest challenge. Areas indistinguishable from DIP may occur focally in otherwise typical UIP, and correlation with the findings on HRCT would be very helpful in that setting. It has been noted that areas typical of NSIP can occur focally in other conditions, making sampling bias a potential barrier to accurate diagnosis. In a review of. Other reports showed no differences in smoking history between patients with NSIP and UIP patterns (4, 16, 19). However, in our study, there were more females and more nonsmokers among patients with NSIP, in contrast to more males and smokers with IPF. Therefore we looked carefully for the possibility of collagen vascular diseases in patients with NSIP by taking a thorough history and.

The Radiology Assistant : Common disease

IPF/UIP (=idiopathic pulmonary fibrosis / usual interstitial pneumonia), NSIP (=nonspecific interstitial pneumonia), Kollagenose, chronische EAA (=extrinsic allergic alveolitis), Sarkoidose Sarkoidose, miliare Tuberkulose, alle granulomatösen, infektiösen Erkrankungen, Histiozytose, LIP (=lymphoid interstitial pneumonia), Metastasen, primäres Bronchialkarzinom Silikose, IPF/UIP (=idiopathic. While histopathologic pattern of usual interstitial pneumonia (UIP) is less common than NSIP in connective tissue-associated ILD, when present a UIP pattern (histopathologically or radiographically) confers a worse survival compared to NSIP . (See Idiopathic interstitial pneumonias: Classification and pathology, section on 'Pathology'. UIP vs. NSIP); in fact, pathological pattern conferred no independent prognostic value. The last bit of evidence comes from a cohort of families affected by familial pulmonary fibrosis where both NSIP and UIP were often found within a single family . Differential diagnosis. The differential diagnosis of IPF includes other idiopathic interstitial pneumonias. HRCT is useful for excluding disease. The importance of radiological evaluation in the discrimination between UIP and NSIP Dr. Figen Ba aran Demirkaz k Hacettepe niversity Department of Radiology - A free PowerPoint PPT presentation (displayed as a Flash slide show) on PowerShow.com - id: 577c8a-Zjky Die idiopathische Lungenfibrose oder idiopathische pulmonale Fibrose (IPF) ist eine sehr schwerwiegende chronische Erkrankung mit oft tödlichem Ausgang, die durch eine stetige Abnahme der Lungenfunktion gekennzeichnet ist. Der Begriff Lungenfibrose steht für eine Vernarbung des Lungengewebes, die zu einer ständig zunehmenden Dyspnoe (Atemnot) führt

Fibrosierende Lungenkrankheite

Idiopathische interstitielle Pneumonie - Wikipedi

  1. Pathologic distinction between NSIP vs. UIP is not definitive. Therefore, pathology is not a reliable gold standard in this paper. The histologic distinction between UIP and NSIP (especially fibrotic NSIP) carries significant inter and intraobserver variability among pathologists. (low interobserver kappa of 0.57
  2. Nonspecific interstitial pneumonia (NSIP) is a chronic interstitial lung disease characterized by homogeneous expansion of the alveolar walls by inflammation or fibrosis or both. NSIP is the second most common chronic interstitial pneumonia, after usual interstitial pneumonia (UIP), accounting for 14% to 35% of cases
  3. ation. 6 After an NSIP pattern is established histologically, a comprehensive evaluation for secondary.
  4. Differentiating fibrosing NSIP from UIP is perhaps the greatest challenge. Areas indistinguishable from DIP may occur focally in otherwise typical UIP, and correlation with the findings on HRCT.
  5. Patients with idiopathic NSIP, cellular pattern had a better 5-and 10-year survival than those with idiopathic NSIP, fibrosing pattern (100% vs 90% and 100% vs 35% respectively, p = 0.027). Survival of patients with idiopathic UIP was worse than that of patients with idiopathic NSIP, fibrosing pattern ( p = 0.014); however, the difference was more evident at 5 years (43% vs 90%) than at 10.

An approach to Interstitial Lung Disease / Diffuse

A single lung transplant was an independent predictor of mortality among recipients with HP at explant pathology on multivariable analysis. Single lung transplant was also an independent predictor for CLAD among patients with NSIP and HP. The rest of the histologic phenotypes UIP, mixed NSIP+UIP ad sarcoid failed to show a significant difference in any of the outcomes by the use of single vs. Patients with NSIP histopathology in lung biopsies (that is, an NSIP pattern) tend to be younger than patients with UIP 61 - 63; the NSIP pattern might also appear in children. 16 As with many of the chronic diffuse lung diseases, symptoms develop gradually. Shortness of breath, cough, fatigue, and weight loss are the most common complaints. Fever and digital clubbing have been reported but. Robert Homer, in Pulmonary Pathology (Second Edition), 2018. Differential Diagnosis . Organizing pneumonia should be differentiated from organizing DAD and constrictive bronchiolitis obliterans. Organizing DAD may show focal intraluminal fibrosis and resemble organizing pneumonia. The distinguishing features of organizing DAD include diffuse rather than patchy distribution, predominantly. Many argue that this begs reassessment of the NSIP vs. UIP system for general characterization of RA-ILD. Clinically, NSIP and UIP pathologies mimic each other very closely, and there is much debate about the two being truly distinct clinical entities, although there is consensus on the differences found in prognosis between them [40, 41] Pathology of UIP. Patchy fibrotic lesions of varying stages (Fibroblastic foci or mature fibrosis and Honeycombing) are mixed within the normal lung parenchyma. Broncho Alveolar Lavarge. It is the marker of alveolitis, which shows lymphocytosis. Pulmonary Function Tests. Restrictive pattern of defect and reduced diffusing capacity for cabon monoxide will be demonstrated on pulmonary function.

Pneumopathie interstitielle diffuse idiopathique — Wikipédi

While an NSIP CT pattern and histology are most common in CTD-ILD, recent work suggests UIP CT features may occur more frequently than previously noted and is highly consistent with underlying UIP pathology . Such radiologic features of advanced disease appear predictive of survival similar to IPF, though in our cohort, similar presenting radiologic patterns were seen between RA-UIP patients. NSIP is a diagnosis of exclusion that requires careful clinical review for possible alternative disorders, in particular connective tissue disorders, hypersensitivity pneumonitis, and drug toxicity. Chest x-ray primarily shows lower-zone reticular opacities. Bilateral patchy opacities are also possible. HRCT findings include bilateral patchy ground-glass attenuation, irregular lines, and. Patchy (RBAILD) vs. diffuse airspace involvement by macrophages; Gerald J Berry MD Robert V Rouse MD Department of Pathology Stanford University School of Medicine Stanford CA 94305-5342 . Original posting/updates: 11/20/1 Start studying Pathology of DPLD. Learn vocabulary, terms, and more with flashcards, games, and other study tools. Home Browse. Create. Search. Log in Sign up. Upgrade to remove ads. Only $2.99/month. Pathology of DPLD. STUDY. Flashcards. Learn . Write. Spell. Test. PLAY. Match. Gravity. Created by. Taylor_GW. Terms in this set (16) Pathogenesis of interstitial lung disease (6) 1. Injury.

UIP Asbestosis RA Chr HSP Diffuse-Late UIP Focal-Many causes CVD Drug Sarcoid PLCH Pneumocon CVD NSIP, CVD HSP, Drugs, Infection, Lymphoma Infection CVD Hemorrhage Infection. CVD, Drug, Hem Synd, CHF, PAP Infection, HSP Sarcoid/Bery Aspiration CVD Infection CVD, COP Smoking Dis Local fibrosis Obstruction Infection Hem Synd Infection, Drug, CVD. Nonfibrotic NSIP and COP/bronchiolitis obliterans organising pneumonia are more likely to have a positive treatment response in comparison to the UIP pattern. Most RA-ILD cases present with a UIP pattern raising the question as to the relative benefits of immunosuppressive versus antifibrotic treatment strategies Usual interstitial pneumonia (UIP) refers to a morphologic entity defined by a combination of (1) patchy interstitial fibrosis with alternating areas of normal lung, (2) temporal heterogeneity of. • Taux de survie des NSIP à 5 ans >50% vs 10-15% pour UIP(IPF) AJRCCM 2002. Diffuse Parenchymal Lung Disease (DPLD) Pneumopathies infiltrantes diffuses (PID) PID de cause connue: médic ou associations (collagénoses, vasculites) Pneumopathies interstitielles idiopathiques (PII) PID sur Granulomatoses (sarcoidosis) Autres formes de PID ( LAM, HX..) Fibrose pulmonaire idiopathique (FPI) PII. one-third of so-called radiologic NSIP may be pathologic UIP Dominated by reticular : and ground-glass findings; honeycombing rare, though has been reported; peripheral and central distribution, often bibasilar more than upper lobe; characteristic sub-pleural sparing may be seen Cryptogenic organizing : pneumonia (COP) May present with waxing and waning : infectious-type symptoms, often.

  1. Die IPF macht 55 %, die NSIP 25 % und die SR-ILD 15 % der Fälle aus. 5 Diagnostik. Keine der diagnostischen Methoden reicht für sich genommen für eine Diagnosestellung einer interstitiellen Lungenerkrankung aus. So ist eine Biopsie, die eine gewöhnliche interstitielle Pneumonie (UIP) zeigt, bei der Diagnose einer idiopathischen Lungenfibrose von Nutzen, findet sich aber auch bei einigen.
  2. (ANA) and non-specific interstitial pneumonia (NSIP) pattern on chest computed tomography (CT). Nineteen had features of UIP either on histopathology or CT imaging. As compared with IPF, IPAF patients had over- all better survival except in those with UIP features. Conclusion: Current IPAF criteria encompassed the majority of broadly defined UCTD-ILD and included those with UIP findings.
  3. CTD-associated ILD is considered to have a better prognosis than idiopathic ILD, whatever the underlying pathology (NSIP or UIP) . However, a recent Asian study suggested that the prognosis for idiopathic NSIP and CTD-associated NSIP was similar . Whether the detection of an anti-SSA(+) antibody in a patient with undefined ILD could affect the management of ILD is unknown. Recently Fischer et.
  4. ance, Honeycombing. Traction . Bronchiectasis. Irregular Reticular . Opacitie
  5. There is a broad differential diagnosis including UIP, advanced NSIP, chronic HP, and CTD-associated ILD among others. The diagnosis of ILD requires a multidisciplinary approach. Correlation with imaging studies and clinical history is suggested. Reference: Smith ML. Update on Pulmonary Fibrosis: Not All Fibrosis Is Created Equally. Arch Pathol Lab Med. 2016 Mar;140(3):221-9. doi: 10.5858/arpa.
  6. The histopathologic pattern of nonspecific interstitial pneumonitis (NSIP) has been found in a wide variety of clinical contexts, including chronic hypersensitivity pneumonitis, drug-related interstitial pneumonia, and connective tissue disease (CTD) [1-5].NSIP has been identified as one of the most common pathologic patterns in patients with CTD [6-11]

Radiological versus histological diagnosis in UIP and NSIP

Ipf or non ipf interstitial lung diseases

Differential diagnosis of usual interstitial pneumonia

Kortikosteroider : Svak respons ved NSIP/UIP type, bra respons ved NSIP/OP og NSIP/HP. DESKVAMATIV INTERSTITIELL PNEUMONI (DIP) Røykere 80% , M>K, Alder 40-50 år Distinkt klinisk fenotyp, men finnes ogsåved eksponering for asbest, nitrofurantoin, anorganiske partikler, ved virale infeksjoner, leukemi, autoimmune sykdommer Familiær DIP Klinisk bilde: progredierende dyspnoe. Sjeldent arter. Prognosis of Fibrotic IPs (NSIP and UIP): Idiopathic vs CTD-Related (Park JH et. Al AJRCCM 2007; 175: 705) IIP 269 pts (203 UIP, 66 NSIP) CTD-IP 93 pts (36 UIP, 57 NSIP) p=0.001 IPF/UIP IPF vs. CTD-UIP Pathologic and Radiologic Differences Between Idiopathic and CTD-Related UIP (Song JW et.al. Chest 2009; 136: 23) Sjogren's RA Germinal Centers are the most common clue to a CTD . AKA.

Pathology Outlines - Usual interstitial pneumonia (UIPPathology Outlines - UIP / IPF

The importance of radiological evaluation in the discrimination between UIP and NSIP Dr. Figen Başaran Demirkazık Hacettepe Üniversity Department of Radiology HRCT Indication 3 Acute pneumonitis UIP vs HP NSIP UIP UIP IPF IPF 4 HP Asbestosis UIP Non IPF 5 NSIP Chronic bronchial inflammation UIP UIP UIP IPF IPF 6 NSIP vs HP Unclassifiable ILD UIP UIP UIP IPF IPF 7 Chronic interstitial fibrosis UIP HP UIP UIP Non IPF IPF BRAVE-1 SLB (+TBB) BRAVE-3 Cryo (+TBB) Central Pathology Central Radiology CONSENT MDT BRAVE-2 Bronch (+TBB) Prospective, 29 US and European site. The clinical-radiographic distinction between idiopathic pulmonary fibrosis (IPF) and non-specific interstitial pneumonia (NSIP) is challenging. We sought to investigate the gene expression profiles of IPF and NSIP vs. normal controls. Gene expression from explanted lungs of patients with IPF (n = 22), NSIP (n = 10) and from normal controls (n = 11) was assessed Practical Pulmonary Pathology (Elsevier 2017) Colby TV. Bronchiolitis: Pathologic considerations. Am J Clin Pathol 1998; 109: 101. www.lungpath.com Pathologic diagnosis in non-neoplastic lung disease requires integration of: 1. Information from four domains: a. Clinical /laboratory (?immunosuppressed) b. Radiologic findings (and Dx/Dx) c. Pathologic injury pattern(s) identified d. Individual

DIP,UIP BIP LIP,GIP Carrington (1978) DIP separate from UIP better prognosis better steroid response Epler/Colby (1985) BOOP 10-20% bilateral/ overlap with UIP on CXR Myers (1987) RBILD Very mild Smoking associated Katzenstein (1994) NSIP Better prognosis Therapy responsive Pulmonary Diseases: Structure-Function Correlation I On a surgical biopsy, what's the main histological difference between UIP and NSIP? In NSIP, there's more cellularity (which correlates to a ground glass type of appearance on HRCT) In UIP, there's holes (which is consistent with the honeycombing) What, actually, is UIP? UIP stands for usual interstitial pneumonia It is a type of HISTOPATHOLOGY that is found in different types of interstitial. Diagnostic Pathology (2012-12-01) . Usual interstitial pneumonia coexisted with nonspecific interstitial pneumonia, What's the diagnosis In pathology, honeycomb lung refers to the characteristic appearance of variably sized cysts in a background of densely scarred lung tissue. Microscopically, enlarged airspaces surrounded by fibrosis with hyperplastic or bronchiolar type epithelium are present. [] However, these changes are nonspecific and are often seen in numerous end-stage interstitial lung diseases (ILDs). [ Nonspecific interstitial pneumonia (NSIP) has been proposed as a histologic subtype of idiopathic interstitial pneumonia with lung biopsy findings that are inconsistent with those of other idiopathic interstitial pneumonias. NSIP has a broad spectrum of histologic findings and a variable prognosi..

NSIP • Celrijke, gemengde en fibrotische vorm • Betere prognose tov UIP • Associaties bijv. - Doorgemaakte DAD - Collageen vasculaire ziekte - Progressieve DIP - Geneesmiddelen - If my pathologist tells me the biopsy shows NSIP, then my job has only just begun T.E. King *Kinder et al. AJRCCM (2007) 176:691- 697 . 5 Organising pneumonia (otherwise referred to as bronchiolitis obliterans organising pneumonia) is characterised histologically by plugs of granulation tissue, which are present predominantly within small airways, alveolar ducts and peri-bronchiolar alveoli. This pattern is not specific for any disorder or cause, but is one type of inflammatory response to pulmonary injury, which may be seen in. Since many of the interstitial pneumonias, including UIP, DIP, and NSIP, fall under this category, it is a non-specific term. Most pathologists who are experts in lung pathology use the terms IPF and UIP to mean the same disease process. To complicate matters even further, European clinicians utilize the term cryptogenic fibrosing alveolitis for IPF. Pathologists also share in the confusion.

UIP CS, MMF initiated 45 F ILD/seronegative RA Anti-synthetase syndrome +ANA, +Jo-1 NSIP MTX added for arthritis 43 F ILD/rheumatic disease Anti-synthetase syndrome +ANA, +PL-12 NSIP CS, MMF changed to CYC 45 M IPF DM +ANA NSIP CS, MMF initiated 49 M ILD/rheumatic disease DM +ANA, +Jo-1 Other CS, MMF initiated 70 The erosion score for AEF was lower than that for UIP and NSIP ( P < 0.01; AEF 0.2 vs UIP 1.6, NSIP 1.1; Fig. a). The mean number of Mallory bodies was lower in AEF (0.1 cells per slide) than in the UIP and NSIP. CLE had neither erosion nor Mallory bodies in this study. Analysis for pneumocyte injury. ( a ) Erosion scores among the lung diseases (with a significant decrease in AEF). ( b ) Ub+. Clinical term vs Histologic term Ex: IPF (clinical) vs UIP (histologic) Idiopathic vs identifiable - Social history important to identify cause ; Characterization of disease based on: Clinical history, radiographic findings, histology, and pulmonary function tests (PFTs) Assessment of Severity - Clinical status (O2 requirements, dyspnea), PFTs, Radiology Important for acute treatment in.

File:UIP Fibroblastic foci 1

Besides, because of severe fibrosis in middle and lower lobes, it was hard to distinguish the lesions of NSIP fibrotic pattern (NSIP-F) or UIP. Based on clinic-radiologic-pathological data, the diagnosis of INSIP-F was made for this patient finally. Our study suggests that UIP is not always an accurate diagnosis when the NSIP and UIP coexist, and NSIP can have regions of UIP.</p> <p>Virtual. One vimentin subtype was upregulated in UIP, while another one was downregulated in NSIP (vs. control). These different characteristics were partially supported by the results of Western blot analysis. Our immunohistochemistry revealed vimentin expression within fibroblasts (a) in fibroblastic foci in UIP and (b) in fibrotic alveolar walls in NSIP

Connective tissue disease-related interstitial lung

fine reticulation. reticular opacities and irregular linear opacities (sometimes - minor subpleural reticulation). Associated Findings. volume loss. traction bronchiectasis. Classical Subpleural Sparing. SCLERODERMA NSIP NSIP CT scan through the chest shows relatively symmetrical and peripherally positioned ground glass infiltrates with a region of subpleural sparing (red arrowhead Lung Pathology Differentials. Asbestosis (peripheral interlobular septal thickening, subpleural findings, parenchymal lines, pleural plaques) Lymphangiomyomatosis (sm muscle proliferations in lymph channels which can also been seen in the kidneys making well cirucumscribed cysts that are uniform in character) ABPA - asthma and CP (IgE > 1000) Accuracy of HRCT for the discrimination between NSIP and UIP: 66% Subpleural Basal Bronchocentric distributions Greater proportion of GGO Finer fibrosis MacDonald SLS et al. Radiology 2001; 221: 600-605 in NSIP than UIP Considerable overlap in thin-section CT pattern

Nonspecific Interstitial Pneumonia: Radiologic, Clinical

Patients with idiopathic NSIP, cellular pattern had a better 5- and 10-year survival than those with idiopathic NSIP, fibrosing pattern (100% vs 90% and 100% vs 35% respectively, p = 0.027). Survival of patients with idiopathic UIP was worse than that of patients with idiopathic NSIP, fibrosing pattern (p = 0.014). The difference, however, was more evident at 5 years (43% vs 90%) than at 10. Hypersensitivity pneumonitis in the aspect of radiology and pathology: findings on imaging i.e. HRCT and pathologic characteristics and how to distinguish it Pathology Uniform Cellularity vs. Fibrotic RA-ILD Histology % NSIP % UIP % Other NSIP? UIP? Who Cares?!?!? Survival for interstitial pneumonitis (all comers) Cellular NSIP > Fibrotic NSIP > UIP RA-ILD Epidemiology •Frequency (19-56%) -Screening asymptomatic vs. symptomatic -Symptoms vs. PFT's -CXR vs. HRCT •NIH sponsored study - 2008 -Screened 64 asymptomatic RA patients •HRCT.

Pathology Outlines - Hypersensitivity pneumonitis
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