Topic
Non-specific interstitial pneumonia
About: Non-specific interstitial pneumonia is a research topic. Over the lifetime, 170 publications have been published within this topic receiving 15112 citations. The topic is also known as: NSIP & Nonspecific interstitial pneumonia (disorder).
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TL;DR: The Diagnostic Process Is Dynamic Clinical Evaluation Radiological Evaluation Role of Surgical Lung Biopsy Unclassifiable Interstitial Pneumonia Bronchoalveolar Lavage Fluid Evaluation Idiopathic Pulmonary Fibrosis.
Abstract: Executive Summary Objectives Participants Evidence Validation Key Messages Introduction Rationale for a Change in the Approach to Classification of Idiopathic Interstitial Pneumonias Development of a New Classification of Idiopathic Interstitial Pneumonia Current Classification of IIP New ATS/ERS Classification Principles Guiding the Assessment of Patients with Idiopathic Interstitial Pneumonias The Diagnostic Process Is Dynamic Clinical Evaluation Radiological Evaluation Role of Surgical Lung Biopsy Unclassifiable Interstitial Pneumonia Bronchoalveolar Lavage Fluid Evaluation Idiopathic Pulmonary Fibrosis Clinical Features Radiologic Features Histologic Features IPF: Areas of Uncertainty Nonspecific Interstitial Pneumonia Clinical Features Radiologic Features Histologic Features NSIP: Areas of Uncertainty Cryptogenic Organizing Pneumonia Clinical Features Radiologic Features Histologic Features COP: Areas of Uncertainty Acute Interstitial Pneumonia Clinical Features Radiologic Features Histologic Features AIP: Areas of Uncertainty Respiratory Bronchiolitis-Associated Interstitial Lung Disease Clinical Features Radiologic Features Histologic Features RB-ILD: Areas of Uncertainty Desquamative Interstitial Pneumonia Clinical Features Radiologic Features Histologic Features DIP: Areas of Uncertainty Lymphoid Interstitial Pneumonia Clinical Features Radiologic Features Histologic Features LIP: Areas of Uncertainty References Appendix
3,591 citations
Woolcock Institute of Medical Research1, University of Otago2, University of Cape Town3, Boston University4, University of California, San Francisco5, University of Wisconsin-Madison6, Creighton University7, University of Arizona8, University of Newcastle9, Erasmus University Rotterdam10, University of Groningen11, University of Edinburgh12, McMaster University13, Imperial College London14, University of Leicester15, University of Amsterdam16, University of Nevada, Reno17, University of Washington18, University of Aberdeen19, University of Pittsburgh20
TL;DR: This update is a supplement to the previous 2002 IIP classification document and outlines advances in the past decade and potential areas for future investigation.
Abstract: Background: In 2002 the American Thoracic Society/European Respiratory Society (ATS/ERS) classification of idiopathic interstitial pneumonias (IIPs) defined seven specific entities, and provided standardized terminology and diagnostic criteria. In addition, the historical “gold standard” of histologic diagnosis was replaced by a multidisciplinary approach. Since 2002 many publications have provided new information about IIPs.Purpose: The objective of this statement is to update the 2002 ATS/ERS classification of IIPs.Methods: An international multidisciplinary panel was formed and developed key questions that were addressed through a review of the literature published between 2000 and 2011.Results: Substantial progress has been made in IIPs since the previous classification. Nonspecific interstitial pneumonia is now better defined. Respiratory bronchiolitis–interstitial lung disease is now commonly diagnosed without surgical biopsy. The clinical course of idiopathic pulmonary fibrosis and nonspecific inte...
2,931 citations
TL;DR: This work states that Idiopathic Pulmonary Fibrosis is a Specific Disease or a Histologic Manifestation of Many Diseases and AIP and UIP are Significance of NSIP.
Abstract: Background Pathologic Classification of Idiopathic Pulmonary Fibrosis UIP DIP/Respiratory Bronchiolitis Interstitial Lung Disease (RBILD) AIP NSIP Clinical Features of the Idiopathic Interstitial Pneumonias UIP DIP/RBILD AIP N SIP Grading of “Cellularity” and Fibrosis Relationship of UIP and DIP Relationship of AIP and UIP Significance of NSIP—A Specific Disease or a Histologic Manifestation of Many Diseases? Summary and Conclusions
1,233 citations
TL;DR: Retrospective analysis of 104 patients with IPF who had open lung biopsy at Mayo Medical Center from 1976 to 1985 was performed to establish the overall survival rate, the spectrum of histopathological subgroups and their associated prognostic significance.
Abstract: Idiopathic pulmonary fibrosis (IPF) is a generally fatal disorder with a reported median survival of 3 to 6 yr. This has been based on relatively few studies with diagnoses inconsistently confirmed by adequate lung biopsy. Retrospective analysis of 104 patients with IPF who had open lung biopsy (OLB) at Mayo Medical Center from 1976 to 1985 was performed to establish the overall survival rate, the spectrum of histopathological subgroups and their associated prognostic significance. The study group consisted of 54 men and 50 women with a median age of 63 yr. Median survival was 3.8 yr after diagnosis by OLB with an estimated 10 yr survival of 27%. Current histopathologic review showed a heterogeneous group including usual interstitial pneumonia (UIP), desquamative interstitial pneumonia (DIP), nonspecific interstitial pneumonia/fibrosis (NSIP), acute interstitial pneumonia (AIP), bronchiolitis, bronchiolitis obliterans organizing pneumonia (BOOP), and others. Median survival of the UIP group was 2.8 yr which is significantly worse (p < 0.001) than for other subgroups of chronic interstitial pneumonias. IPF includes several histopathologic subgroups with significantly different survival rates. Patients with UIP have worse survival than patients with other types of idiopathic chronic interstitial pneumonias including NSIP. Accurate histopathologic classification is essential for prognostication in patients with IPF.
997 citations
TL;DR: These cases, descriptively termed nonspecific interstitial pneumonia fibrosis, were characterized by varying proportions of interstitial inflammation and fibrosis that appeared to be occurring over a single time span (i.e., the process was temporally uniform.)
Abstract: Sixty-four cases of interstitial pneumonia were identified that could not be classified into one of three main categories of idiopathic interstitial pneumonia. These cases, descriptively termed nonspecific interstitial pneumonia/fibrosis, were characterized by varying proportions of interstitial inflammation and fibrosis that appeared to be occurring over a single time span (i.e., the process was temporally uniform.) The most common presenting complaint was dyspnea for several months, and chest radiographs usually showed bilateral interstitial infiltrates. The prognosis was good with only five deaths due to progressive respiratory disease in 48 patients with known follow-up (11%). No deaths occurred in patients whose biopsies showed pure inflammation and no fibrosis. Nonspecific interstitial pneumonia must be separated from the three main forms of idiopathic interstitial pneumonia because of better prognosis and different treatment options. It should not be considered a specific disease, however, because it may have varying etiologies including underlying connective tissue diseases, organic dust or other exposures, and prior acute lung injury; less often, it may reflect a nonrepresentative biopsy of another process.
700 citations