Figures
- Figure 1.
Classification of interstitial lung disease. EG: eosinophilic granulomatosis; EP: eosinophilic pneumonia; LAM: lymphangioleiomyomatosis. Reproduced and modified from [1] with permission from the publisher.
- Figure 2.
2011 American Thoracic Society/European Respiratory Society/Japanese Respiratory Society/Latin American Thoracic Association diagnostic algorithm for idiopathic pulmonary fibrosis (IPF). ILD: interstitial lung disease; HRCT: high-resolution computed tomography; UIP: usual interstitial pneumonia; MDD: multidisciplinary discussion. Reproduced and modified from [11] with permission from the publisher.
Tables
- Table 1. Clinical conditions associated with a histopathological pattern of usual interstitial pneumonia
Idiopathic pulmonary fibrosis/cryptogenic fibrosing alveolitis Collagen vascular disease Drug toxicity Chronic hypersensitivity pneumonitis Asbestosis Familial idiopathic pulmonary fibrosis Hermansky–Pudlak syndrome Reproduced from [1] with permission from the publisher.
- Table 2. 2002 American Thoracic Society/European Respiratory Society criteria for the diagnosis of idiopathic pulmonary fibrosis
Major criteria Exclusion of other known causes of ILD, such as certain drug toxicities, environmental exposures and connective tissue diseases Abnormal pulmonary function studies that include evidence of restriction (reduced VC, often with an increased FEV1/FVC ratio) and impaired gas exchange (increased PA–aO2, decreased PaO2 with rest or exercise, or decreased DLCO) Bibasilar reticular abnormalities with minimal ground-glass opacities on HRCT Transbronchial lung biopsy or BAL showing no features to support an alternative diagnosis Minor criteria Age >50 years Insidious onset of otherwise unexplained dyspnoea on exertion Duration of illness >3 months Bibasilar, inspiratory crackles (dry or “Velcro”-type in quality) In the immunocompetent adult, the presence of all of the major diagnostic criteria as well as at least three of the four minor criteria increases the likelihood of a correct clinical diagnosis of idiopathic pulmonary fibrosis. See figure 2 for the updated 2011 criteria. ILD: interstitial lung disease; VC: vital capacity; FEV1: forced expiratory volume in 1 s; FVC: forced vital capacity; PA–aO2: alveolar–arterial oxygen tension difference; PaO2: arterial oxygen tension; DLCO: diffusing capacity of the lung for carbon monoxide; HRCT: high-resolution computed tomography; BAL: bronchoalveolar lavage. Data from [10].
- Table 3. Radiological features of idiopathic pulmonary fibrosis
UIP pattern (all four features) Possible UIP pattern (all three features) Inconsistent with UIP pattern (any one of seven features) Subpleural basal predominance Subpleural basal predominance Upper or mid-lung predominance Peribronchovascular predominance Reticular abnormality Reticular abnormality Extensive ground-glass abnormality (extent greater than reticular abnormality) Profuse micronodules (bilateral, predominantly upper lobes) Honeycombing with or without traction bronchiectasis Discrete cysts (multiple bilateral, away from areas of honeycombing) Diffuse mosaic attenuation/air trapping (bilateral in three or more lobes) Absence of features listed as inconsistent with UIP pattern Absence of features listed as inconsistent with UIP pattern Consolidation in bronchopulmonary segment(s)/lobe(s) UIP: usual interstitial pneumonia. Reproduced and modified from [11] with permission from the publisher.
Disclosures
Files in this Data Supplement:
