At low magnification, the main change in sections of the wedge lung biopsy is chronic intersititaal pneumonia characterized by a combination of inflamation and fibrosis. At least focally the fibrosis predominates and has a somewhat patchy distribution. It also includes areas of architectural distortion in the form of subpleural honeycomb change. While the fibrosis consists mainly of dense collegen depositions there are scattered fibroblast foci. The combination of findings establish the diagnosis of UIP. An unusuure feature is the presence of lymphoid hyperplasia in the form of peribronchiolar lymphoid aggregates. This is a relatively nonspecific finding although it is seen more commonly in patients with underlying systemic connective tissue disease compared to patients with idiopathic pulmonary fibrosis. In a sense this finding is consistent with the patients history of mixed connective tissue disease.
Dr Jeffery Myers at the University of Michigan Dept. of Pathology
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