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Imaging Features of Systemic Sclerosis-Associated Interstitial Lung Disease
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Published on: June 16, 2020

Desquamative interstitial pneumonia

Henry D Tazelaar1, Joanne L Wright, Andrew Churg

  • 1Department of Laboratory Medicine and Pathology, Mayo Clinic in Arizona, Scottsdale, AZ 85050, USA. tazelaar.henry@mayo.edu

Histopathology
|September 22, 2010
PubMed

Insights

Desquamative interstitial pneumonia (DIP) is a rare lung disease characterized by macrophage accumulation. While often linked to smoking, other inhaled agents can cause DIP, which has a better prognosis than related fibrotic lung diseases.

Area of Science:

  • Pulmonology
  • Pathology

Background:

  • Desquamative interstitial pneumonia (DIP) is a rare idiopathic interstitial pneumonia.
  • It involves significant accumulation of macrophages in alveolar spaces, often containing brown pigment ('smoker's macrophages').
  • Associated findings include interstitial inflammation, fibrosis, lymphoid nodules, and eosinophil infiltrates.

Purpose of the Study:

  • To describe the key pathological features of Desquamative interstitial pneumonia (DIP).
  • To discuss the etiology, including smoking and other inhaled agents.
  • To differentiate DIP from related lung conditions like respiratory bronchiolitis-interstitial lung disease (RB-ILD) and fibrotic non-specific interstitial pneumonia (NSIP) based on prognostic factors.

Main Methods:

  • Histopathological examination of lung tissue.
  • Clinical correlation of findings with patient history, including smoking and exposure history.
  • Comparative analysis with other interstitial lung diseases.

Main Results:

  • DIP is characterized by abundant macrophages in alveoli, often pigmented.
  • Cigarette smoking is the most common cause, but marijuana smoke and other inhaled agents can also induce DIP.
  • DIP shows distinct features from RB-ILD, and its prognosis is generally better than fibrotic NSIP, despite potential morphological overlap.

Conclusions:

  • DIP is a distinct clinicopathological entity, primarily associated with smoking.
  • Distinguishing DIP from fibrotic NSIP is crucial for accurate prognosis and management.
  • While most DIP patients respond to treatment, some may develop progressive fibrosis.

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