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Usual interstitial pneumonia: histologic study of biopsy and explant specimens.
Am J Surg Pathol. 2002 Dec; 26(12):1567-77.AJ

Abstract

The pathologic findings in biopsy and subsequent explant specimens from 20 patients with usual interstitial pneumonia (UIP) were reviewed to refine histologic criteria for diagnosis, to identify factors that may confound diagnosis, and to assess the relationship of UIP and nonspecific interstitial pneumonia (NSIP). One case of NSIP was also identified and included for comparison. Surgical biopsies from 15 of the 20 UIP cases were diagnosed as UIP, whereas 5 showed only nondiagnostic changes. An important new observation is that areas resembling nonspecific interstitial pneumonia (NSIP-like areas) are present in the majority of UIP cases in both biopsy and explant specimens, and they are extensive in some. Ten of the 15 UIP biopsies were considered straightforward, with typical patchy interstitial fibrosis, honeycomb change, and fibroblast foci. Five cases were considered difficult because of prominent NSIP-like areas in two, extensive honeycomb change in one, superimposed diffuse alveolar damage in one, and superimposed bronchiolitis obliterans-organizing pneumonia in one. The most helpful feature for diagnosing UIP in difficult cases was the presence of a distinct patchwork appearance to the characteristic uneven or variegated parenchymal involvement along with evidence of architectural derangement. No explant showing UIP was preceded by biopsy findings of NSIP, and the one NSIP case appeared similar at biopsy and explant. NSIP or NSIP-like areas and UIP may reflect different mechanisms of fibrosis related either to different severity of injury or to different injuries.

Authors+Show Affiliations

Department of Pathology, SUNY Upstate Medical University and Crouse Hospital, 736 Irving Avenue, Syracuse, NY 13210, USA. katzensteina@pol.netNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

12459623

Citation

Katzenstein, Anna-Luise A., et al. "Usual Interstitial Pneumonia: Histologic Study of Biopsy and Explant Specimens." The American Journal of Surgical Pathology, vol. 26, no. 12, 2002, pp. 1567-77.
Katzenstein AL, Zisman DA, Litzky LA, et al. Usual interstitial pneumonia: histologic study of biopsy and explant specimens. Am J Surg Pathol. 2002;26(12):1567-77.
Katzenstein, A. L., Zisman, D. A., Litzky, L. A., Nguyen, B. T., & Kotloff, R. M. (2002). Usual interstitial pneumonia: histologic study of biopsy and explant specimens. The American Journal of Surgical Pathology, 26(12), 1567-77.
Katzenstein AL, et al. Usual Interstitial Pneumonia: Histologic Study of Biopsy and Explant Specimens. Am J Surg Pathol. 2002;26(12):1567-77. PubMed PMID: 12459623.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Usual interstitial pneumonia: histologic study of biopsy and explant specimens. AU - Katzenstein,Anna-Luise A, AU - Zisman,David A, AU - Litzky,Leslie A, AU - Nguyen,Binh T, AU - Kotloff,Robert M, PY - 2002/12/3/pubmed PY - 2002/12/19/medline PY - 2002/12/3/entrez SP - 1567 EP - 77 JF - The American journal of surgical pathology JO - Am J Surg Pathol VL - 26 IS - 12 N2 - The pathologic findings in biopsy and subsequent explant specimens from 20 patients with usual interstitial pneumonia (UIP) were reviewed to refine histologic criteria for diagnosis, to identify factors that may confound diagnosis, and to assess the relationship of UIP and nonspecific interstitial pneumonia (NSIP). One case of NSIP was also identified and included for comparison. Surgical biopsies from 15 of the 20 UIP cases were diagnosed as UIP, whereas 5 showed only nondiagnostic changes. An important new observation is that areas resembling nonspecific interstitial pneumonia (NSIP-like areas) are present in the majority of UIP cases in both biopsy and explant specimens, and they are extensive in some. Ten of the 15 UIP biopsies were considered straightforward, with typical patchy interstitial fibrosis, honeycomb change, and fibroblast foci. Five cases were considered difficult because of prominent NSIP-like areas in two, extensive honeycomb change in one, superimposed diffuse alveolar damage in one, and superimposed bronchiolitis obliterans-organizing pneumonia in one. The most helpful feature for diagnosing UIP in difficult cases was the presence of a distinct patchwork appearance to the characteristic uneven or variegated parenchymal involvement along with evidence of architectural derangement. No explant showing UIP was preceded by biopsy findings of NSIP, and the one NSIP case appeared similar at biopsy and explant. NSIP or NSIP-like areas and UIP may reflect different mechanisms of fibrosis related either to different severity of injury or to different injuries. SN - 0147-5185 UR - https://www.unboundmedicine.com/medline/citation/12459623/Usual_interstitial_pneumonia:_histologic_study_of_biopsy_and_explant_specimens_ L2 - https://doi.org/10.1097/00000478-200212000-00004 DB - PRIME DP - Unbound Medicine ER -