Difference between revisions of "Lymphocytic interstitial pneumonia"

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#redirect [[Diffuse_lung_diseases#Lymphocytic_interstitial_pneumonia]]
{{ Infobox diagnosis
| Name      = {{PAGENAME}}
| Image      = Lymphocytic interstitial pneumonia -- intermed mag.jpg
| Width      =
| Caption    = Lymphocytic interstitial pneumonia. [[H&E stain]].
| Synonyms  =
| Micro      = small mature lymphocytes in the interstitium of the lung, plasma cells, +/-lymphoid follicles
| Subtypes  =
| LMDDx      = [[lymphoma]] - see ''[[lymphoma of lung]]'', [[follicular bronchitis/bronchiolitis]], [[pulmonary nodular lymphoid hyperplasia|nodular lymphoid hyperplasia]]
| Stains    =
| IHC        =
| EM        =
| Molecular  =
| IF        =
| Gross      =
| Grossing  =
| Staging    =
| Site      = [[lung]] - see ''[[diffuse lung diseases]]''
| Assdx      = autoimmune disorders ([[rheumatoid arthritis]], [[pernicious anemia]], [[Sjoegren syndrome]]), viral infections ([[HIV]], [[EBV]], human T-cell leukemia virus (HTLV) type 1)
| Syndromes  =
| Clinicalhx = dependent on underlying cause - see ''associated diagnoses''
| Signs      =
| Symptoms  =
| Prevalence = rare
| Bloodwork  =
| Rads      = basilar predominance, increased interstitial markings
| Endoscopy  =
| Prognosis  =
| Other      =
| ClinDDx    =
| Tx        =
}}
'''Lymphocytic interstitial pneumonia''' (abbreviated '''LIP'''), also known as '''lymphoid interstitial pneumonia''' and '''lymphocytic interstitial pneumonitis''', is an uncommon [[diffuse lung disease]].


==General==
*Associated with autoimmune disorders ([[rheumatoid arthritis]], [[pernicious anemia]], [[Sjoegren syndrome]])<ref>URL: [http://emedicine.medscape.com/article/299643-overview http://emedicine.medscape.com/article/299643-overview]. Accessed on: 2 June 2010.</ref> and immunodeficiency.<ref name=pmid16088689>{{cite journal |author=Nicholson AG |title=Lymphocytic interstitial pneumonia and other lymphoproliferative disorders in the lung |journal=Semin Respir Crit Care Med |volume=22 |issue=4 |pages=409–22 |year=2001 |month=August |pmid=16088689 |doi=10.1055/s-2001-17384 |url=}}</ref>
*Associated with viral infections ([[HIV]], [[EBV]], human T-cell leukemia virus (HTLV) type 1).
**Considered an AIDS-defining diagnosis.<ref name=pmid7893443>{{Cite journal  | last1 = Turner | first1 = BJ. | last2 = Eppes | first2 = S. | last3 = McKee | first3 = LJ. | last4 = Cosler | first4 = L. | last5 = Markson | first5 = LE. | title = A population-based comparison of the clinical course of children and adults with AIDS. | journal = AIDS | volume = 9 | issue = 1 | pages = 65-72 | month = Jan | year = 1995 | doi =  | PMID = 7893443 }}</ref>
==Gross==
*Location: basilar predominance.
*Increased interstitial markings.
==Microscopic==
Features:<ref>URL: [http://emedicine.medscape.com/article/299643-diagnosis http://emedicine.medscape.com/article/299643-diagnosis]. Accessed on: 2 June 2010.</ref>
*Small mature lymphocytes (usually B cells)<ref name=afip_vol2_265>AFIP atlas of nontumour pathology. 2002. Vo. 2. P.265. ISBN 1-881041-79-4.</ref> in the interstitium of the lung.
*Plasma cells.
*+/-Lymphoid follicles.
Negatives:
*No [[vasculitis]].
*No [[necrosis]].
DDx:
*[[Lymphoma]].
*[[Follicular bronchitis/bronchiolitis]].
*[[Pulmonary nodular lymphoid hyperplasia|Nodular lymphoid hyperplasia]].
**This is determined in part by radiology; it has nodules radiographically.
*[[Non-specific interstitial pneumonia]] - less inflammation.
===Images===
====Case====
<gallery>
Image: Lymphocytic interstitial pneumonia -- extremely low mag.jpg | LIP - ext. low mag. (WC/Nephron)
Image: Lymphocytic interstitial pneumonia -- very low mag.jpg | LIP - very low mag. (WC/Nephron)
Image: Lymphocytic interstitial pneumonia -- low mag.jpg | LIP - low mag. (WC/Nephron)
Image: Lymphocytic interstitial pneumonia -- intermed mag.jpg | LIP - intermed. mag. (WC/Nephron)
Image: Lymphocytic interstitial pneumonia -- high mag.jpg | LIP - high mag. (WC/Nephron)
Image: Lymphocytic interstitial pneumonia -- very high mag.jpg | LIP - very high mag. (WC/Nephron)
<gallery/>
<gallery>
Image: Lymphocytic interstitial pneumonia and normal -- very low mag.jpg | LIP & normal - very low mag. (WC/Nephron)
Image: Lymphocytic interstitial pneumonia and normal -- low mag.jpg | LIP & normal - low mag. (WC/Nephron)
Image: Lymphocytic interstitial pneumonia and normal - alt -- low mag.jpg | LIP & normal - low mag. (WC/Nephron)
Image: Lymphocytic interstitial pneumonia and normal -- intermed mag.jpg | LIP & normal - intermed mag. (WC/Nephron)
Image: Lymphocytic interstitial pneumonia and normal -- high mag.jpg | LIP & normal - high mag. (WC/Nephron)
</gallery>
====www====
*[http://www.scielo.br/img/revistas/jbpneu/v34n2/en_a02fig01.jpg LIP (scielo.br)].
*[http://path.upmc.edu/cases/case176/micro.html LIP (upmc.edu)].
==Stains==
To exclude infection:<ref>URL: [http://path.upmc.edu/cases/case176/dx.html http://path.upmc.edu/cases/case176/dx.html]. Accessed on: 8 January 2012.</ref>
*[[GMS stain]] -ve.
*[[Ziehl-Neelsen stain]] -ve.
==IHC==
*May be done to exclude lymphoma.
==See also==
*[[Diffuse lung diseases]].
==References==
{{Reflist|2}}
[[Category:Diffuse lung diseases]]
[[Category:Diagnosis]]
[[Category:Diagnosis]]

Latest revision as of 13:30, 10 May 2016

Lymphocytic interstitial pneumonia
Diagnosis in short

Lymphocytic interstitial pneumonia. H&E stain.
LM small mature lymphocytes in the interstitium of the lung, plasma cells, +/-lymphoid follicles
LM DDx lymphoma - see lymphoma of lung, follicular bronchitis/bronchiolitis, nodular lymphoid hyperplasia
Site lung - see diffuse lung diseases
Associated Dx autoimmune disorders (rheumatoid arthritis, pernicious anemia, Sjoegren syndrome), viral infections (HIV, EBV, human T-cell leukemia virus (HTLV) type 1)
Clinical history dependent on underlying cause - see associated diagnoses
Prevalence rare
Radiology basilar predominance, increased interstitial markings

Lymphocytic interstitial pneumonia (abbreviated LIP), also known as lymphoid interstitial pneumonia and lymphocytic interstitial pneumonitis, is an uncommon diffuse lung disease.

General

Gross

  • Location: basilar predominance.
  • Increased interstitial markings.

Microscopic

Features:[4]

  • Small mature lymphocytes (usually B cells)[5] in the interstitium of the lung.
  • Plasma cells.
  • +/-Lymphoid follicles.

Negatives:

DDx:

Images

Case

  • LIP - ext. low mag. (WC/Nephron)

  • LIP - very low mag. (WC/Nephron)

  • LIP - low mag. (WC/Nephron)

  • LIP - intermed. mag. (WC/Nephron)

  • LIP - high mag. (WC/Nephron)

  • LIP - very high mag. (WC/Nephron)

  • LIP & normal - very low mag. (WC/Nephron)

  • LIP & normal - low mag. (WC/Nephron)

  • LIP & normal - low mag. (WC/Nephron)

  • LIP & normal - intermed mag. (WC/Nephron)

  • LIP & normal - high mag. (WC/Nephron)

www

Stains

To exclude infection:[6]

IHC

  • May be done to exclude lymphoma.

See also

References

  1. ↑ URL: http://emedicine.medscape.com/article/299643-overview. Accessed on: 2 June 2010.
  2. ↑ Nicholson AG (August 2001). "Lymphocytic interstitial pneumonia and other lymphoproliferative disorders in the lung". Semin Respir Crit Care Med 22 (4): 409–22. doi:10.1055/s-2001-17384. PMID 16088689.
  3. ↑ Turner, BJ.; Eppes, S.; McKee, LJ.; Cosler, L.; Markson, LE. (Jan 1995). "A population-based comparison of the clinical course of children and adults with AIDS.". AIDS 9 (1): 65-72. PMID 7893443.
  4. ↑ URL: http://emedicine.medscape.com/article/299643-diagnosis. Accessed on: 2 June 2010.
  5. ↑ AFIP atlas of nontumour pathology. 2002. Vo. 2. P.265. ISBN 1-881041-79-4.
  6. ↑ URL: http://path.upmc.edu/cases/case176/dx.html. Accessed on: 8 January 2012.
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