Alveolar Septa Diseases

Question 1

Usual Interstitial Pneumonia (UIP)

Answer 1

• patchy heterogeneous fibrosis by collagen
• fibroblastic foci
• honeycomb cystic changes (never gets better)(worst in lower lobes)
• heterogeneity between zones. not in one stage all at once

Question 2

Non-specific interstitial pneumonia (NSIP)

Answer 2

• uniform inflammation in septa (cellular)
• uniform fibrosis in septa (fibrotic stage)
• can be mix of both stages
• few if any fibroblastic foci or honeycomb change
• some respond to immunosuppression

NSIP presents similarly to other ILD
May be idiopathic, collagen vascular disease- related (RA, Sjögren’s, scleroderma, myositis), fibrotic HP, or drug-related.
More likely to be female; younger.
Prognosis is better than UIP/IPF, and collagen vascular-related may have better prognosis than idiopathic.
Responds to anti-inflammatory therapy. Corticosteroids or steroid sparing drugs

Question 3

hypersensitivity pneumonia (HP)

Answer 3

• airway centered chronic inflammation
• nonnecrotizing granulomas
• focal organizing pneumonia
• variable fibrosis
• response to foreign antigens (birds, mold, hot-tub bacteria, mycobacteria)
• worse around airway at lung top

Question 4

Pulmonary fibrosis

Answer 4

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