Lymphocytic interstitial pneumonia associated with the acquired immune deficiency syndrome

Lymphocytic interstitial pneumonitis (LIP) is characterized by interstitial accumulation of mature lymphocytes, plasma cells, and reticuloendothelial cells and is often an unremitting process unresponsive to immunosuppressive therapy. The patient described in this report had severe candidal esophagitis and immunologic findings consistent with the acquired immune deficiency syndrome (AIDS). There was no evidence of pulmonary infection with Pneumocystis carinii, cytomegalovirus, Mycobacterium avium-intracellulare, or Cryptococcus neoformans. Open lung biopsy revealed multiple discrete nodular foci of inflammation and alveolar inflammation. The inflammatory cells were largely lymphocytes and histiocytes. Thus, LIP may be an infrequent complication of AIDS. Epstein-Barr virus and Chlamydia trachomatis are potential etiologic agents, but a specific cause remains to be identified. This disorder has been described with a higher frequency in pediatric AIDS.