Interstitial Lung Disease

Question 1

What are the different categories of diffuse lung disease?

Answer 1

Drug induced
Granulomatous
Other
Idiopathic interstitial pneumonitis:
 =- Usual interstitial pneumonia/IPF
= Nonspecific interstitial pneumonia
= Cryptogenic organising pneumonia
= AIP, RBILD, DIP, LIP

Question 2

Common cause of granulomatous lung disease?

Answer 2

Sarcoidosis

–> nodular lung infiltrates in mid and upper zones
Mediastinal and hilar LAD

Question 3

What is pLAM?

Answer 3

Lymphangioleiomyomatosis
Premenopausal female esp. tuberous sclerosis
–> cystic lung disease

Question 4

What is COP?

Answer 4

Consolidation in lower zones + ground glass changes + pulmonary nodules + pleural thickening

Granulation + fibrin + collagen

Caused by connective tissue diseases, drugs and as a post infective complication

Question 5

Rare ILD significant features?

Answer 5

DIP = smoking related - stop smoking –> resolution

AIP = ARDS equivalent = hyaline membrane

Question 6

NSIP features

Answer 6

Bilateral patchy and subpleural areas of ground glass in the lower zones
NO HONEYCOMBING
Temporal distribution of changes

Question 7

UIP features

Answer 7

High mortality at 2 yrs
Predominantly Male ex smokers
Present with progressive SOB

HONEYCOMBING
Temporal heterogeneity

Refer for lung transplant
Treat with prednisone
New treatments = Pirfenidone and nintedanib