A usual interstitial pneumonia (UIP) pattern on chest CT scans is highly suggestive of UIP pathologic findings; the most common cause of UIP is idiopathic pulmonary fibrosis (IPF) [1–5].Under current guidelines, a UIP pattern on CT images is specific for IPF after a thorough clinical and serologic workup has excluded other causes of interstitial lung disease (ILD) []. Case Discussion. Materials and Methods: Institutional review board approval was obtained for this retrospective study; informed consent was not required. Crossref, Medline, Google Scholar; 28 Kim EY, Lee KS, Chung MP, Kwon OJ, Kim TS, Hwang JH. The study included 54 patients with NSIP and … This outcome is quite different from that seen in UIP, which has a poor prognosis. Idiopathic pulmonary fibrosis (IPF), the most common and lethal of the idiopathic interstitial pneumonias, is defined by a radiological and/or pathological pattern of usual interstitial pneumonia (UIP). Radiological versus histological diagnosis in UIP and NSIP: survival implications. UIP/IPF – histologic section Spatial heterogeneity: fibrosis with interspersed normal lung 34. Link, Google Scholar; 27 Flaherty KR, Thwaite EL, Kazerooni EA, et al. NSIP may be idiopathic or associated with collagen vascular diseases or exposure to drugs or chemicals. UIP/IPF – gross specimen White tissue represents interstitial fibrosis 33. Thorax 2003; 58: 143–148. NSIP; Diagnostic Criteria. Take a quiz on differentiating between chronic hypersensitivity pneumonitis (HP), nonspecific interstitial pneumonia (NSIP), and usual interstitial pneumonia (UIP). In NSIP, fine reticular opacities and microcystic honeycombing represent fibosis while ground glass opacities without traction bronchiectatic changes possibly represent inflammation. 35 Organizing pneumonia is characterized by the presence of consolidation and may also show features of fibrosis reminiscent of NSIP. Cryptogenic Organizing Pneumonia. Pathological classification. Clinical; Insidious onset of dyspnea, cough, fatigue; Mean age 40-50, may be seen in children; Pulmonary function tests: restrictive with decreased diffusing capacity; Generally less severe than UIP; Overall 80=90% 5 year survival Responds to steroids; High resolution computed tomography (HRCT) In a study by McDonald and coworkers of 21 patients with NSIP and 32 patients with UIP, the sensitivity, specificity, and accuracy of a CT diagnosis of NSIP were 70, 63, and 66%, respectively . 10 Purpose: To determine whether concurrent emphysema influences the distinction between usual interstitial pneumonia (UIP) and nonspecific interstitial pneumonia (NSIP) at thin-section computed tomography (CT). Differentiating Chronic HP, NSIP, & UIP – Radiology Rounds {Extrapulmonary manifestations 35. 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. UIP/IPF – gross specimen Small, firm, fibrosed lung seen in advanced disease 32. LIP lymphoid interstitial pneumonia, NSIP nonspecific interstitial pneumonia, RB-ILD respiratory bronchiolitis–associated interstitial lung disease, UIP usual interstitial pneumonia RadioGraphics 2007; 27:595–615 Published online 10.1148/rg.273065130 Content Code: Several studies have evaluated the ability to differentiate between UIP and NSIP by HRCT. Three pathologists (TVC, WDT, AF) blinded to the clinical and radiological features reviewed the biopsy specimens. It can be normal in early stage of disease and in plain radiographs. Each specimen was assigned a histological diagnosis of UIP or NSIP using defined criteria. 3, 19 A patient received a diagnosis of UIP when one or more biopsy specimens showed UIP. NSIP 36. NSIP has a relative good prognosis and the majority of patients respond to treatment with corticosteroids. Radiology 2007; 245: 267–275. There is a well known association of NSIP with SLE..
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