UIP/IPF – histologic section Spatial heterogeneity: fibrosis with interspersed normal lung 34. NSIP has a relative good prognosis and the majority of patients respond to treatment with corticosteroids. It can be normal in early stage of disease and in plain radiographs. Radiological versus histological diagnosis in UIP and NSIP: survival implications. Cryptogenic Organizing Pneumonia. 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). NSIP; Diagnostic Criteria. NSIP 36. 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) []. Pathological classification. Three pathologists (TVC, WDT, AF) blinded to the clinical and radiological features reviewed the biopsy specimens. NSIP may be idiopathic or associated with collagen vascular diseases or exposure to drugs or chemicals. Differentiating Chronic HP, NSIP, & UIP – Radiology Rounds 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) UIP/IPF – gross specimen White tissue represents interstitial fibrosis 33. Each specimen was assigned a histological diagnosis of UIP or NSIP using defined criteria. There is a well known association of NSIP with SLE.. Thorax 2003; 58: 143–148. Take a quiz on differentiating between chronic hypersensitivity pneumonitis (HP), nonspecific interstitial pneumonia (NSIP), and usual interstitial pneumonia (UIP). UIP/IPF – gross specimen Small, firm, fibrosed lung seen in advanced disease 32. Several studies have evaluated the ability to differentiate between UIP and NSIP by HRCT. 3, 19 A patient received a diagnosis of UIP when one or more biopsy specimens showed UIP. 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 . {Extrapulmonary manifestations 35. 10 The study included 54 patients with NSIP and … 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. Radiology 2007; 245: 267–275. 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). Materials and Methods: Institutional review board approval was obtained for this retrospective study; informed consent was not required. This outcome is quite different from that seen in UIP, which has a poor prognosis. 35 Organizing pneumonia is characterized by the presence of consolidation and may also show features of fibrosis reminiscent of NSIP. Case Discussion. Crossref, Medline, Google Scholar; 28 Kim EY, Lee KS, Chung MP, Kwon OJ, Kim TS, Hwang JH. Link, Google Scholar; 27 Flaherty KR, Thwaite EL, Kazerooni EA, et al. 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: In NSIP, fine reticular opacities and microcystic honeycombing represent fibosis while ground glass opacities without traction bronchiectatic changes possibly represent inflammation. 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