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Open Access Case Report

Usual interstitial pneumonia coexisted with nonspecific interstitial pneumonia, What’s the diagnosis?

Xia Fang1, Benfang Luo3, Xianghua Yi1*, Yu Zeng1, Fang Liu1, Huiping Li2, Pan Gu1, Xuyou Zhu1, Suxia Zhang1 and Gelin Jiang2

Author Affiliations

1 Department of Pathology, Tongji Hospital, Tongji University School of Medicine, Shanghai, 200065, China

2 Department of Respiratory medicine, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, 200433, China

3 Department of Special Examination, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, 200433, China

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Diagnostic Pathology 2012, 7:167  doi:10.1186/1746-1596-7-167

Published: 3 December 2012

Abstract

The differential diagnosis between idiopathic nonspecific interstitial pneumonia(INSIP) and idiopathic pulmonary fibrosis(IPF)/usual interstitial pneumonia(UIP)is tough in both clinicians and pathologists. In this study, we analyzed the lesions of right lung removed from a 58-year-old patient by gross and microscopy. The results showed that the pathological appearance of nonspecific interstitial pneumonia (NSIP) and UIP coexisted in his upper lobe. Besides, because of severe fibrosis in middle and lower lobes, it was hard to distinguish the lesions of NSIP fibrotic pattern (NSIP-F) or UIP. Based on clinic-radiologic-pathological data, the diagnosis of INSIP-F was made for this patient finally. Our study suggests that UIP is not always an accurate diagnosis when the NSIP and UIP coexist, and NSIP can have regions of UIP.

Virtual slide

The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/2573531681608730

Keywords:
Nonspecific interstitial pneumonia; Usual interstitial pneumonia; Idiopathic nonspecific interstitial pneumonia; Diagnosis