Table 1 Radiological and pathological signs suggestive of an interstitial lung disease in the framework of an autoimmune disease
From: The usual Interstitial pneumonia pattern in autoimmune rheumatic diseases
Ancillary finding | Definition | |
|---|---|---|
Radiological | Anterior upper lobe sign | Concomitant fibrosis with honeycombing in the anterior part of the upper lobe combined with a UIP pattern with a predominant basal distribution |
Straight-edge sign | Sparing of the upper and midzones from fibrosis with a horizontal demarcation between fibrotic and normal lung parenchyma, without cranial extension of fibrosis along the lateral chest wall | |
Exuberant honeycombing | Honeycomb cysts comprising more than 70% of the fibrotic lung areas. | |
Pathological | Dense lymphoplasmacytic infiltrates | Nodular aggregates of limphocytes often with a prominent germinal centre |
Pleuritis | Unexplained pleural inflammation of the serosal surfaces (with or without hyperplastic germinal centre) | |
Nonspecific interstitial pneumonia | Non-fibrotic lung parenchyma may show a slight lymphocyte infiltrate | |
Organizing pneumonia | Organizing pneumonia polyps with typical endoalveolar projection | |
Overlap patterns (UIP/NSIP/OP) | Association of different patterns variously combined |