What Every Radiologist Should Know about Idiopathic Interstitial ...
Idiopathic Interstitial Pneumonias-short
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Transcript of 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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