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Clinical and radiological features of idiopathic interstitial pneumonias (IIPs): a pictorial review.
Insights Imaging. 2014 Jun; 5(3):347-64.II

Abstract

OBJECTIVES

To illustrate the clinical and radiological features of idiopathic interstitial pneumonias (IIPs), according to the American Thoracic Society (ATS)/European Respiratory Society (ERS) classification updated in 2013.

METHODS

IIPs include a subset of diffuse and restrictive lung diseases, resulting from damage to the parenchyma characterised by inflammation and fibrosis of the interstitium. Classification into major and rare IIPs is based on the 2013 ATS/ERS committee.

RESULTS

The diagnosis of idiopathic pulmonary fibrosis (IPF) needs to exclude other well-known causes of interstitial lung diseases. According to the 2011 evidence-based guidelines, usual interstitial pneumonia (UIP) can be diagnosed by HRCT when all criteria are fulfilled. Non-specific interstitial pneumonia (NSIP) is characterised by patchy ground-glass opacities and irregular linear/reticular opacities. The imaging patterns of respiratory bronchiolitis associated-interstitial lung disease (RB-ILD) and desquamative interstitial pneumonia (DIP) show centrolobular nodules and ground-glass opacities. Cryptogenic organising pneumonia (COP) consists of patchy peripheral or peribronchial consolidations, while ground-glass opacities are typically associated with diffuse lung consolidation, evolving to fibrosis, in acute interstitial pneumonia (AIP). Rare IIPs include lymphoid interstitial pneumonia and idiopathic pleuro-parenchymal fibroelastosis (IPPFE).

CONCLUSIONS

The knowledge of IIP imaging features on HRCT images help radiologists in diagnosis. Moreover, the overlap of imaging features needs a multidisciplinary approach.

TEACHING POINTS

• UIP findings are reticulations, bronchiectasis, honeycombing and absence of inconsistent features. • Bilateral patchy ground-glass areas represent the most encountered features in NSIP. • Poorly defined centrilobular nodules are typical of RB-ILD, whereas a ground-glass appearance is typical of DIP. • HRCT features of COP include characteristic peripheral or peribronchial patchy consolidations. • Rare IIPs include idiopathic LIP and idiopathic pleuro-parenchymal fibroelastosis (PPFE).

Authors+Show Affiliations

Radiodiagnostic and Radiotherapy Unit, University Hospital Policlinico-Vittorio Emanuele, Via Santa Sofia 78, 95123, Catania, Italy, spalmucci@sirm.org.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

24844883

Citation

Palmucci, Stefano, et al. "Clinical and Radiological Features of Idiopathic Interstitial Pneumonias (IIPs): a Pictorial Review." Insights Into Imaging, vol. 5, no. 3, 2014, pp. 347-64.
Palmucci S, Roccasalva F, Puglisi S, et al. Clinical and radiological features of idiopathic interstitial pneumonias (IIPs): a pictorial review. Insights into imaging. 2014;5(3):347-64.
Palmucci, S., Roccasalva, F., Puglisi, S., Torrisi, S. E., Vindigni, V., Mauro, L. A., Ettorre, G. C., Piccoli, M., & Vancheri, C. (2014). Clinical and radiological features of idiopathic interstitial pneumonias (IIPs): a pictorial review. Insights Into Imaging, 5(3), 347-64. https://doi.org/10.1007/s13244-014-0335-3
Palmucci S, et al. Clinical and Radiological Features of Idiopathic Interstitial Pneumonias (IIPs): a Pictorial Review. Insights into imaging. 2014;5(3):347-64. PubMed PMID: 24844883.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical and radiological features of idiopathic interstitial pneumonias (IIPs): a pictorial review. AU - Palmucci,Stefano, AU - Roccasalva,Federica, AU - Puglisi,Silvia, AU - Torrisi,Sebastiano Emanuele, AU - Vindigni,Virginia, AU - Mauro,Letizia Antonella, AU - Ettorre,Giovanni Carlo, AU - Piccoli,Marina, AU - Vancheri,Carlo, Y1 - 2014/05/22/ PY - 2014/03/13/received PY - 2014/04/15/accepted PY - 2014/04/10/revised PY - 2014/5/22/entrez PY - 2014/5/23/pubmed PY - 2014/5/23/medline SP - 347 EP - 64 JF - Insights into imaging VL - 5 IS - 3 N2 - OBJECTIVES: To illustrate the clinical and radiological features of idiopathic interstitial pneumonias (IIPs), according to the American Thoracic Society (ATS)/European Respiratory Society (ERS) classification updated in 2013. METHODS: IIPs include a subset of diffuse and restrictive lung diseases, resulting from damage to the parenchyma characterised by inflammation and fibrosis of the interstitium. Classification into major and rare IIPs is based on the 2013 ATS/ERS committee. RESULTS: The diagnosis of idiopathic pulmonary fibrosis (IPF) needs to exclude other well-known causes of interstitial lung diseases. According to the 2011 evidence-based guidelines, usual interstitial pneumonia (UIP) can be diagnosed by HRCT when all criteria are fulfilled. Non-specific interstitial pneumonia (NSIP) is characterised by patchy ground-glass opacities and irregular linear/reticular opacities. The imaging patterns of respiratory bronchiolitis associated-interstitial lung disease (RB-ILD) and desquamative interstitial pneumonia (DIP) show centrolobular nodules and ground-glass opacities. Cryptogenic organising pneumonia (COP) consists of patchy peripheral or peribronchial consolidations, while ground-glass opacities are typically associated with diffuse lung consolidation, evolving to fibrosis, in acute interstitial pneumonia (AIP). Rare IIPs include lymphoid interstitial pneumonia and idiopathic pleuro-parenchymal fibroelastosis (IPPFE). CONCLUSIONS: The knowledge of IIP imaging features on HRCT images help radiologists in diagnosis. Moreover, the overlap of imaging features needs a multidisciplinary approach. TEACHING POINTS: • UIP findings are reticulations, bronchiectasis, honeycombing and absence of inconsistent features. • Bilateral patchy ground-glass areas represent the most encountered features in NSIP. • Poorly defined centrilobular nodules are typical of RB-ILD, whereas a ground-glass appearance is typical of DIP. • HRCT features of COP include characteristic peripheral or peribronchial patchy consolidations. • Rare IIPs include idiopathic LIP and idiopathic pleuro-parenchymal fibroelastosis (PPFE). SN - 1869-4101 UR - https://www.unboundmedicine.com/medline/citation/24844883/Clinical_and_radiological_features_of_idiopathic_interstitial_pneumonias__IIPs_:_a_pictorial_review_ L2 - https://dx.doi.org/10.1007/s13244-014-0335-3 DB - PRIME DP - Unbound Medicine ER -
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