Usual interstitial pneumonia

Case contributed by Dr Prashant Mudgal

Presentation

Progressive dyspnoea, dry cough and weight loss for the last 3 months

Patient Data

Age: 52 years
Gender: Male
Modality: X-ray

There is increased peripheral/subpleural reticular opacities with an apicobasal gradient and reduced lung volume suggestive of underlying fibrotic lung disease.

Modality: CT

There are ground glass opacities as well as interlobular and subpleural intersitial septal thickening with a predominate peripheral and basal distribution. Traction bronchiolectasis is present in the region of affected lung . Layers of honeycombing cysts are present in the basal segments of the right lower lobe and lesser degree in the left lower lobe. Overall the lung volume is reduced. Reactive mediastinal lymph nodes noted. Imaging findings is compatible with usual interstitial pneumonia (UIP) pattern fibrosis. 

 

Case Discussion

UIP is a histological term adopted to describe a pattern of interstitial fibrosis characterised by peripheral and basal interstitial fibrosis and presence of honeycombing cysts. If no cause is identified this is known as idiopathic pulmonary fibrosis (IPF). Alternatively UIP pattern can be observed in several endstage fibrotic lung disease including collagen vascular disease, asbestosis, hypersensitivity pneumonitis, sarcoidosis and drug reaction. If HRCT finding is equivocal biopsy maybe required to distinguish UIP from fibrotic non specific interstitial pneumonia (NSIP).  

 

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Case Information

rID: 34877
Case created: 12th Mar 2015
Last edited: 8th Dec 2015
System: Chest
Inclusion in quiz mode: Included

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