A Practical Approach to the Diagnosis of Diffuse Lung Diseases

Most commonly affects young adults

Is a chronic lung disease that does not respond to therapy

Frequently has associated small sarcoid-like pulmonary granulomas

Patients are at decreased risk for lung cancer compared to smokers

UIP rarely ever occurs without renal involvement at presentation

Fatal cardiac disease

Peripheral blood eosinophilia

Airspace organization

Positive p-ANCA serology

Bell sign on CT scans

Ground glass infiltrates in upper lobes

Reticulation with subpleural sparing

Airway-centered nodules at the lung bases

Honeycomb cysts at the lung bases peripherally

Honeycomb cysts in the upper lobes

The idiopathic form is commonly associated with epilepsy.

Patients frequently present with localized or unilateral disease

Diagnosis requires rigorous exclusion of lymphoma

Must never be treated with antibiotics

Progresses to lymphoma if untreated

Lymphoid interstitial pneumonia (LIP)

Desquamative interstitial pneumonia (DIP)

Acute interstitial pneumonia (AIP)

Giant cell interstitial pneumonia (GIP)

Cryptogenic organizing pneumonia (COP)

Chronic cellular infiltrates with small interstitial granulomas

Diffuse organizing pneumonia with hyaline membranes

Eosinophils in alveolar spaces, fibrin, and reactive type II cells

Necrotizing vasculitis, siderophages, and granulomas

Capillaritis, Arthus reaction, granulomas

Pulmonary granulomas in sarcoidosis are confined to the airways

Young adults are most commonly affected

Interstitial pulmonary fibrosis is common and is often accompanied by honeycomb cysts

When the lungs are involved sarcoidosis is an aggressive disease

Sarcoidosis produces a Sickle Sign on CT scan

Disease commonly affects the lung bases at presentation

Interstitial fibrosis is common and often accompanied by honeycomb cysts

Nodules or cysts in the upper lung zones are the most common findings

Is an aggressive clinical disease when the lungs are involved

Produces an Atoll Sign on CT scan

Is a fatal disease for most patients

Is often associated with asthma

Was first described by Liebow

Is an aggressive clinical disease when the heart is involved

Has a better prognosis than UIP

Hypoxic, restrictive, obstructive, and tussive

Airway, parenchymal, perilymphatic, and cystic

Hypoxemic, paroxysmal, restrictive and obstructive

Acute, subacute, and chronic presentations

Peripheral, central, localized

Acute bronchopneumonia

Usual interstitial pneumonia (UIP)

Eosinophilic pneumonia

Desquamative interstitial pneumonia (DIP)

Lymphoid interstitial pneumonia (LIP)

Usual interstitial pneumonia (UIP)

Histiocytosis X

Langerhans cell histiocytosis

Desquamative interstitial pneumonia (DIP)

Acute interstitial pneumonia (AIP)

Pattern 1 Acute lung injury

Pattern 2 Fibrosis

Pattern 3 Cellular infiltrates

Pattern 4 Alveolar filling

Pattern 5 Nodules

Pattern 6 Minimal changes

Blue bodies

Acute bronchopneumonia

Microscopic honeycombing

Giant cell interstitial pneumonia

Desquamative interstitial pneumonia

Acute interstitial pneumonia (AIP)

Usual interstitial pneumonia (UIP)

Desquamative interstitial pneumonia (DIP)

Nonspecific interstitial pneumonia (NSIP)

Sacroidosis

Sarcoidosis

Metastatic carcinoma

Langerhans cell histiocytosis

Intravenous talcosis

Pulmonary parasitosis

Consolidation

Linear and reticular opacities

Mosaic perfusion

Ground glass attenuation

Nodules

Consolidation

Linear and reticular opacities

Mosaic perfusion

Ground glass attenuation

Nodules

Ground glass infiltrates

Reticular and linear opacities

Nodules

Mosaic perfusion

Cysts

Cystic fibrosis

Erdheim Chester Disease

Lymphangioleiomyomatosis (LAM)

Emphysema

Pulmonary Langerhans cell histiocytosis