Classification of usual interstitial pneumonia
in patients with interstitial lung disease: assessment of a machine learning approach using high-dimensional transcriptional data.
Pulmonary hypertension is a co-morbidity seen in 30%-85% of patients with idiopathic interstitial pneumonia
(IIP) and is associated with increased mortality.
Pathologically, AEs show a combination of an underlying fibrotic interstitial pneumonia
and a superimposed form of acute lung injury, either diffuse alveolar damage (DAD) or organizing pneumonia (OP) (6).
In typical patients, investigation directed to all these diagnoses may not be needed, but infectious causes had to be excluded in our patient, since she presented at an older age and atypical findings including interstitial pneumonia
in addition to typical findings including lymphadenopathy, polymorphous exanthem, bilateral conjunctival congestion and peeling of the skin on the tips of fingers.
The definitive diagnosis--by high-resolution computed tomography (HRCT) and/or surgical lung biopsy--depends on the finding of what is referred to as a usual interstitial pneumonia
(UIP) pattern, (1), (4) as distinct from an NSIP pattern.
The following is a nonexhaustive review of the pathology of some of the small airways diseases, specifically cellular bronchiolitis, including follicular bronchiolitis and diffuse panbronchiolitis; granulomatous bronchiolitis; tobacco smoke-associated small airways bronchiolitic diseases, hypersensitivity pneumonitis; organizing pneumonia; constrictive bronchiolitis; mineral dust exposure and various other exposure-associated bronchiolitic diseases; and 4 recently described bronchiolitic disorders, bronchiolitic disease due to ingestion of Sauropus androgynus, airway-centered interstitial fibrosis, idiopathic bronchiolocentric interstitial pneumonia
, and bronchiolitis interstitial pneumonitis.
This finding is based on the following evidence: 1) some persons who had met him in Hanoi before his departure reported that he had fatigue and fits of cough; 2) the passengers closest to him on the plane reported that he was dyspneic; and 3) his initial evaluation at admission to hospital on March 23 showed bilateral extended interstitial pneumonia
The fibrosis in DAD tends to be loose and myxoid and will appear bluish-gray on hematoxylin-eosin sections, in contrast to the collagenous fibrosis typically seen in other disorders such as nonspecific interstitial pneumonia
and usual interstitial pneumonia
Chest x-ray results were normal for eight teenagers but showed linear interstitial pneumonia
for one teenager.
Nodular lymphoid hyperplasia differs from lymphocytic interstitial pneumonia
in that it is focal rather than diffuse.
Radiographic findings were nonspecific and differed greatly among the patients, who exhibited single and multiple opacities, diffuse interstitial pneumonia
, and pleural effusion (in one patient).
The DPF cases fell into the following diagnostic categories: usual interstitial pneumonia
(77%), nonspecific interstitial pneumonia
(6%), desquamative interstitial pneumonia
(4%), polymyositis-associated interstitial fibrosis (1%), and not further classified or unclassified fibrosis (12%).