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[A clinicopathologic study of nonspecific interstitial pneumonia]
Xianghua Yi1, Guojun He, Di Zheng
1Department of Pathology, Shanghai Pulmonary Hospital, Shanghai 200433, China.
Objective:
To investigate the clinicopathologic features of nonspecific interstitial pneumonia (NSIP).
Methods:
The clinical and pathological data of 8 cases with NSIP confirmed by open or video-assisted thoracoscopic lung biopsy were reviewed retrospectively.
Results:
NSIP occurred more in female (male:female 1:3, 2/6), and the patients' average age was 48 years. The clinical manifestation was progressive dyspnea, cough and sputum, crackles over both lungs and restrictive ventilating abnormalities. Reticular changes and patchy ground-glass attenuation in lower lung fields were the main findings on high resolution computed tomography. The pathological characteristic was uniform interstitial inflammation and fibrosis. Three cases showed fibroblast foci, was BOOP like changes in 4 and honeycombing in 1 case. of the 8 patients, 6 had cellular and fibrosing patterns; 2 had fibrosing patterns only; the former showed better response to glucocorticoid therapy than the latter.
Conclusions:
The histologic patterns of NSIP correlated closely with the therapeutic effect of glucocorticoids. It is difficult to differentiate pathologically the fibrosing pattern of NSIP from usual interstitial pneumonia, therefore clinical data are indispensable in the diagnosis.