Idiopathic Interstitial Pneumonias-short

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    What every Radiologist

    Should Know about

    diopathic nterstitial

    Pneumonias

    Presented by: dr. Agus Darwiyanto

    Lectured by: dr. H. Undang Ruhimat,Sp.Rad

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    Idiopathic Interstitial

    Pneumonias (IIPs) Idiopathic Interstitial Pnemonias (IIPs) published in

    2002

    Diagnosed Based on clinical-radiologic-pathologic.

    There is seven entities in IIPs

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    7 entities in IIPs

    Idiopathic pulmonary fibrosis

    Nonspecific interstitial pneumonia (NSIP)

    Cryptogenic Organizing Pneumonia (COP) Respiratory bronchiolitis-associated interstitial lung

    disease (RB-ILD)

    Desquamative intersttitial pneumonia (DIP)

    Lymphoid interstitial pneumonia (ILP) Acute interstitial pneumonia (AIP)

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    CT findings

    In UIP:

    Basal ground opacities tend to predominate andperipheral reticular opacities w/ honeycombing

    In NSIP:

    Basal ground glass opacities tend to predominateover reticular opacities, w/ traction bronchiectasisin advanced disease

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    CT findings

    In COP:

    Patchy peripheral or peribronchovascularconsolidation

    In RB-ILD and DIP:

    Smoking related disease

    Centrilobular nodules and groun glass opacities.

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    How to Diagnose IIPs?

    Correct diagnosis of IIPs can be achieved only bymeans of interdisciplinary consensus and stringentcorrelation of:

    clinical,

    imaging, and

    pathologic findings

    The key role that radiologist play in the work-up of

    IIPs necessitates a through knowledege of thepatterns as described in internationalclassification.

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    Idiopathic Pulmonary

    Fibrosis (IPF)

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    Idiopathic Pulmonary

    Fibrosis (IPF)

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    Idiopathic Pulmonary

    Fibrosis (IPF)

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    8 major and minor criteria

    Histologic confirmation should be obtained.

    Idiopathic Pulmonary

    Fibrosis (IPF)

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    Non Specific Interstitial

    Pneumonia (NSIP) Les common than UIP

    Distinction from UIP is given better respons tocorticosteroid therapy.

    Histologic pattern is characterized by temporallyand spatially homogenouslung

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    Non Specific Interstitial

    Pneumonia (NSIP)

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    Non Specific Interstitial

    Pneumonia (NSIP)

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    Non Specific Interstitial

    Pneumonia (NSIP)

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    Non Specific Interstitial

    Pneumonia (NSIP)

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    Compare UIP and NSIP

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    Cryptogenic Organizing

    Pneumonia

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    Cryptogenic Organizing

    Pneumonia

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    Cryptogenic Organizing

    Pneumonia

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    Respiratory Bronchiolitis-associatedInterstitial Lung Disease (RB-ILD)

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    Respiratory Bronchiolitis-associatedInterstitial Lung Disease (RB-ILD)

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    Respiratory Bronchiolitis-associatedInterstitial Lung Disease (RB-ILD)

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    Desquamative Interstitial

    Pneumonia (DIP)

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    Lymphoid Interstitial

    Pneumonia (LIP)

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    Lymphoid Interstitial

    Pneumonia (LIP)

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    Lymphoid Interstitial

    Pneumonia (LIP)

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    Acute Interstitial

    Pneumonia (AIP)

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    Acute Interstitial

    Pneumonia (AIP)

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    The CT appearances of UIP and COP may be diagnostic in theappropriate clinical context

    Conclusion

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    Therefore, accurate diagnosis of these disordersrequires a dynamic interdisciplinary approachthat correlates clinical, radiologic, and pathologic

    features.

    Conclusion

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    Ground-glass opacities can be caused by:

    normal expiration,

    partial filling of air spaces,

    partial collapse of alveoli,

    interstitial thickening,

    inflammation,

    oedema,

    fibrosis, and

    lepidic proliferationof neoplasm.

    http://radiopaedia.org/articles/missing?article[title]=lepidic-proliferationhttp://radiopaedia.org/articles/missing?article[title]=lepidic-proliferationhttp://radiopaedia.org/articles/missing?article[title]=lepidic-proliferation
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    NonSpesific InterstitialPneumonia

    Memiliki gambaranyang hampir samadengan IPF

    Terdapat infiltratdifus bilateral

    Jarang didapatigambaranhoneycombing

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    CryptogenicOrganizingPneumonia

    Unilateral / bilateralpatcy consolidation

    Distribusinyabiasanyaperibronkial atausubpleura

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    RespiratoryBronchiolitisassociated InterstitialLung Disease

    Groundglassopacity

    Centrilobulermicronodule

    Centrilobularemphysema

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    DesquamativeInterstitial Pneumonia

    Gambaranmenyerupai RB-ILD

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    Lymphoid InterstitialPneumonia

    Retikuler atauretikulonoduler difusbilateral

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