• Title/Summary/Keyword: Interstitial pneumonia

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특발성간질성폐렴의 방사선학적 소견 (Idiopathic Interstitial Pneumonias : Radiologic Findings)

  • 이경수
    • Tuberculosis and Respiratory Diseases
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    • 제54권2호
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    • pp.129-144
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    • 2003
  • Usual interstitial pneumonia/Idiopathic pulmonary fibrosis, nonspecific interstitial pneumonia, Cryptogenic organizing pneumonia(bronchiolitis obliterans organizing pneumonia : BOOP), Acute interstitial pneumonia, respiratory bronchiolitis-associated interstitial lung disease, Desquamative interstitial pneumonia, Lymphoid interstitial pneumonia.

사이질 폐병의 최신지견: 특발사이질 폐렴을 중심으로 (Clinical Year in Review of Interstitial Lung Diseases: Focused on Idiopathic Interstitial Pneumonia)

  • 리원연
    • Tuberculosis and Respiratory Diseases
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    • 제67권4호
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    • pp.275-280
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    • 2009
  • Interstitial lung disease (ILD) is a group of diseases characterized by pulmonary interstitial inflammation. Finally the inflammation results in pulmonary fibrosis and impairment of oxygen transportation. The causes of idiopathic interstitial pneumonia (IIP) are unknown. Diagnosis of IIP is not easy, especially distinguising between nonspecific interstitial pneumonia and usual interstitial pneumonia (UIP). First line treatments of IIP include corticosteroids and immune modulators, which have limited effect. Currently, several drugs are being researched to prevent and treat fibrosis. Newer drugs that may useful to treat pulmonary fibrosis include endothelin receptor antagonist, recombinant soluble TNF receptor antagonist, and cotrimoxazole. The causes of IIP are largely unknown, treatment is not specific, and prognosis is poor. Recent studies are underway to investigate the pathogenesis and treatment of IIP and pulmonary fibrosis. As the pathogenesis of IIP is elucidated, better treatments will emerge.

특발성 간질성 폐렴의 영상 소견 (Radiologic Findings of Idiopathic Interstitial Pneumonia)

  • 박재성
    • Tuberculosis and Respiratory Diseases
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    • 제58권4호
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    • pp.330-343
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    • 2005
  • 특발성 간질성 폐렴은 폐포보다는 폐간질을 주로 침범하는 미만성 염증성 섬유화 병변으로 병변의 분류에 임상적 및 병리학적으로 많은 혼동과 변화를 겪어왔다. 최근에는 미국흉부학회와 유럽호흡기학회의 공동 모임에서 이 질환 군에 해당되는 모든 임상과들이 모여서 7가지의 병변으로 재분류 하였는데, 이는 Idiopathic pulmonary fibrosis, Nonspecific interstitial pneumonia, Cryptogenic organizing pneumonia, Acute interstitial pneumonia, Respiratory bronchiolitis interstitial lung disease, Desquamative interstitial pneumonia, Lymphocytic interstitial pneumonia 등이다. 이에 저자는 최근 분류에 의한 특발성 간질성 폐렴의 7가지 병변을 영상 소견을 중심으로 기술하고자 한다.

Spectrum of Pulmonary Fibrosis from Interstitial Lung Abnormality to Usual Interstitial Pneumonia: Importance of Identification and Quantification of Traction Bronchiectasis in Patient Management

  • Takuya Hino;Kyung Soo Lee;Joungho Han;Akinori Hata;Kousei Ishigami;Hiroto Hatabu
    • Korean Journal of Radiology
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    • 제22권5호
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    • pp.811-828
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    • 2021
  • Following the introduction of a novel pathological concept of usual interstitial pneumonia (UIP) by Liebow and Carrington in 1969, diffuse interstitial pneumonia has evolved into UIP, nonspecific interstitial pneumonia (NSIP), and interstitial lung abnormality (ILA); the histopathological and CT findings of these conditions reflect the required multidisciplinary team approach, involving pulmonologists, radiologists, and pathologists, for their diagnosis and management. Concomitantly, traction bronchiectasis and bronchiolectasis have been recognized as the most persistent and important indices of the severity and prognosis of fibrotic lung diseases. The traction bronchiectasis index (TBI) can stratify the prognoses of patients with ILAs. In this review, the evolutionary concepts of UIP, NSIP, and ILAs are summarized in tables and figures, with a demonstration of the correlation between CT findings and pathologic evaluation. The CT-based UIP score is being proposed to facilitate a better understanding of the spectrum of pulmonary fibrosis, from ILAs to UIP, with emphasis on traction bronchiectasis/bronchiolectasis.

폐섬유화를 동반한 재발성 박리성 간질성 폐렴 (Recurrent Desquamative Interstitial Pneumonia with Fibrotic Lung Disease)

  • 김원진;최정희;박용범;조성우;남은숙;모은경
    • Tuberculosis and Respiratory Diseases
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    • 제65권4호
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    • pp.328-333
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    • 2008
  • 박리성 간질성 폐렴은 흡연가에 호발하는 비교적 드문 미만성 간질성 폐질환이다. 박리성 간질성 폐렴은 치료에 대한 반응과 예후가 좋은 질환이나, 재발하는 경우가 있고 치료기간이 명확히 정해져 있지 않으며, 심한 섬유화가 동반되는 경우는 드문 질환이다. 저자들은 흉부 전산화단층 촬영에서 견인성 기관지확장증과 초기의 벌집모양 폐 소견과 함께 미만성 간유리혼탁화를 보이는 환자에서 흉강경하 폐 조직 검사로 박리성 간질성 폐렴을 진단하였고, 치료 종결 후 재발한 박리성 간질성 폐렴을 경험하였기에 이를 보고하는 바이다.

New Era of Management Concept on Pulmonary Fibrosis with Revisiting Framework of Interstitial Lung Diseases

  • Azuma, Arata;Richeldi, Luca
    • Tuberculosis and Respiratory Diseases
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    • 제83권3호
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    • pp.195-200
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    • 2020
  • The disease concept of interstitial lung disease with idiopathic pulmonary fibrosis at its core has been relied on for many years depending on morphological classification. The separation of non-specific interstitial pneumonia with a relatively good prognosis from usual interstitial pneumonia is also based on the perception that morphology enables predict the prognosis. Beginning with dust-exposed lungs, initially, interstitial pneumonia is classified by anatomical pathology. Diagnostic imaging has dramatically improved the diagnostic technology for surviving patients through the introduction of high-resolution computed tomography scan. And now, with the introduction of therapeutics, the direction of diagnosis is turning. It can be broadly classified into to make known the importance of early diagnosis, and to understand the importance of predicting the speed of progression/deterioration of pathological conditions. For this reason, the insight of "early lesions" has been discussed. There are reports that the presence or absence of interstitial lung abnormalities affects the prognosis. Searching for a biomarker is another prognostic indicator search. However, as is the case with many chronic diseases, pathological conditions that progress linearly are extremely rare. Rather, it progresses while changing in response to environmental factors. In interstitial lung disease, deterioration of respiratory functions most closely reflect prognosis. Treatment is determined by combining dynamic indicators as faithful indicators of restrictive impairments. Reconsidering the history being classified under the disease concept, the need to reorganize treatment targets based on common pathological phenotype is under discussed. What is the disease concept? That aspect changes with the discussion of improving prognosis.

Pathological interpretation of connective tissue disease-associated lung diseases

  • Kwon, Kun Young
    • Journal of Yeungnam Medical Science
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    • 제36권1호
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    • pp.8-15
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    • 2019
  • Connective tissue diseases (CTDs) can affect all compartments of the lungs, including airways, alveoli, interstitium, vessels, and pleura. CTD-associated lung diseases (CTD-LDs) may present as diffuse lung disease or as focal lesions, and there is significant heterogeneity between the individual CTDs in their clinical and pathological manifestations. CTD-LDs may presage the clinical diagnosis a primary CTD, or it may develop in the context of an established CTD diagnosis. CTD-LDs reveal acute, chronic or mixed pattern of lung and pleural manifestations. Histopathological findings of diverse morphological changes can be present in CTD-LDs airway lesions (chronic bronchitis/bronchiolitis, follicular bronchiolitis, etc.), interstitial lung diseases (nonspecific interstitial pneumonia/fibrosis, usual interstitial pneumonia, lymphocytic interstitial pneumonia, diffuse alveolar damage, and organizing pneumonia), pleural changes (acute fibrinous or chronic fibrous pleuritis), and vascular changes (vasculitis, capillaritis, pulmonary hemorrhage, etc.). CTD patients can be exposed to various infectious diseases when taking immunosuppressive drugs. Histopathological patterns of CTD-LDs are generally nonspecific, and other diseases that can cause similar lesions in the lungs must be considered before the diagnosis of CTD-LDs. A multidisciplinary team involving pathologists, clinicians, and radiologists can adequately make a proper diagnosis of CTD-LDs.

Korean Guidelines for Diagnosis and Management of Interstitial Lung Diseases: Part 1. Introduction

  • Park, Sung-Woo;Baek, Ae Rin;Lee, Hong Lyeol;Jeong, Sung Whan;Yang, Sei-Hoon;Kim, Yong Hyun;Chung, Man Pyo;Korean Interstitial Lung Diseases Study Group
    • Tuberculosis and Respiratory Diseases
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    • 제82권4호
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    • pp.269-276
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    • 2019
  • Idiopathic interstitial pneumonia (IIP) is a histologically identifiable pulmonary disease without a known cause that usually infiltrates the lung interstitium. IIP is largely classified into idiopathic pulmonary fibrosis, idiopathic non-specific interstitial pneumonia, respiratory bronchiolitis-interstitial lung disease (ILD), cryptogenic organizing pneumonia, desquamative interstitial pneumonia, and acute interstitial pneumonia. Each of these diseases has a different prognosis and requires specific treatment, and a multidisciplinary approach that combines chest high-resolution computed tomography (HRCT), histological findings, and clinical findings is necessary for their diagnosis. Diagnosis of IIP is made based on clinical presentation, chest HRCT findings, results of pulmonary function tests, and histological findings. For histological diagnosis, video-assisted thoracoscopic biopsy and transbronchial lung biopsy are used. In order to identify ILD associated with connective tissue disease, autoimmune antibody tests may also be necessary. Many biomarkers associated with disease prognosis have been recently discovered, and future research on their clinical significance is necessary. The diagnosis of ILD is difficult because patterns of ILD are both complicated and variable. Therefore, as with other diseases, accurate history taking and meticulous physical examination are crucial.