Diagnostic Approach to Interstitial Pneumonias in a Single Centre: Report on 88 Cases

Overview

Journal Diagn Pathol

Publisher Biomed Central

Specialty Pathology

Date 2012 Nov 28

PMID 23181688

Citations 9

Authors

Dirk Theegarten

Heike Maria Muller

Francesco Bonella

Jeremias Wohlschlaeger

Ulrich Costabel

Affiliations

Soon will be listed here.

Abstract

Background: Interstitial pneumonias (IP) cover a broad spectrum of diseases. Open lung biopsies reveal histological patterns and suggest possible diagnoses. Complete clinical records are necessary for final diagnoses. Especially idiopathic interstitial pneumonias (IIP) according to the ATS/ERS classification can only be diagnosed under these predictions. The aim of this study was to compare the results of histological evaluations with the final diagnosis after interdisciplinary case evaluation.

Patients And Methods: 88 patients with interstitial pneumonia that underwent open lung biopsies were investigated. Histology and clinical records were available for review. Diagnosis was made in three steps: first on the sole basis of histology, second with clinical information given initially and third, on the basis of an interdisciplinary case evaluation.

Results: 63 patients (72%) were diagnosed as idiopathic interstitial pneumonias according to ATS/ERS criteria. Further 10 (11%) cases of hypersensitivity pneumonitis, 7 (8%) Langerhans cell histiocytosis and 8 (9%) interstitial pneumonias of other known causes or associations were detected. Histological patterns alone agreed with the final diagnosis in 67%. In 82% histology and clinical information given to the pathologist could provide correct diagnosis. In the rest of cases, especially in non idiopathic interstitial pneumonias, an interdisciplinary case evaluation was needed.

Conclusions: Diagnosis of interstitial pneumonias by open lung biopsies needs sufficient clinical information. Because of the overlap of histological patterns, an interdisciplinary case evaluation that includes at least one clinical expert and one pathologist with excellent expertise and the follow-up of the patients is necessary to find correct diagnosis in all cases.

Virtual Slides: The virtual slides for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/5031706258025129.

Citing Articles

Multidisciplinary Approach to the Diagnosis of Idiopathic Interstitial Pneumonias: Focus on the Pathologist's Key Role.

Luca S, Pagliuca F, Perrotta F, Ronchi A, Mariniello D, Natale G Int J Mol Sci. 2024; 25(7).

PMID: 38612431 PMC: 11011777. DOI: 10.3390/ijms25073618.

Guidelines of the Polish Respiratory Society on the Diagnosis and Treatment of Progressive Fibrosing Interstitial Lung Diseases Other than Idiopathic Pulmonary Fibrosis.

Piotrowski W, Martusewicz-Boros M, Bialas A, Barczyk A, Batko B, Blasinska K Adv Respir Med. 2022; 90(5):425-450.

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Bleeding risk of transbronchial cryobiopsy compared to transbronchial forceps biopsy in interstitial lung disease - a prospective, randomized, multicentre cross-over trial.

Hetzel J, Eberhardt R, Petermann C, Gesierich W, Darwiche K, Hagmeyer L Respir Res. 2019; 20(1):140.

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The diagnostic value of the bronchoalveolar lavage in interstitial lung diseases.

Efared B, Ebang-Atsame G, Rabiou S, Diarra A, Tahiri L, Hammas N J Negat Results Biomed. 2017; 16(1):4.

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Pulmonary Langerhans cell histiocytosis with cervical lymph node involvement, and coexistence with pulmonary tuberculosis and right pneumothorax: a case report and review of literature.

Gao L, Li H, Li G, Liu W, Li J, Zhang W Int J Clin Exp Pathol. 2015; 8(2):2146-52.

PMID: 25973117 PMC: 4396240.

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