特發性間質性肺炎
特發性間質肺炎（Idiopathic interstitial pneumonia，簡稱IIP），又稱非感染性肺炎（noninfectious pneumonia）[1]，屬於一種間質性肺病。該疾病通常侵襲肺間質，有些也會侵襲氣道（例如Cryptogenic organizing pneumonitis），IIP可分為七個亞型。
組織學分類 编辑
IIP的分類相當複雜[2]，須結合臨床觀察、影像學，以及病理学[3][4]才能確診。
| 組織學 | 臨床相關意義 |
|---|---|
| Desquamative interstitial pneumonia (DIP) | DIP |
| Diffuse alveolar damage (DAD) | 急性呼吸窘迫症候群、急性間質性肺炎、輸血相關急性肺損傷 |
| 非特異性間質性肺炎（NSIP） | NSIP |
| Respiratory bronchiolitis | 呼吸性細支氣管相關之間質性肺病（RB-ILD） |
| 尋常性間質性肺炎 (UIP) | 自體免疫性疾病、特发性肺纤维化、致死量、肺塵病 |
| Organizing pneumonia | 隱源性機化性肺炎 |
| 淋巴樣間質性肺炎 (LIP) | LIP |
其中尋常性間質性肺炎為最常見的一種亞型[7]。
發育 编辑
Table 1: Development of the (histologic) idiopathic interstitial pneumonia classification
| Leibow et al. (1969) | Katzenstein (1998)[8] | ATS/ERS (2002)[6] | |||||||||||||||||||||||||||
| UIP | UIP | ||||||||||||||||||||||||||||
| UIP | DAD | DAD | |||||||||||||||||||||||||||
| NSIP | NSIP | ||||||||||||||||||||||||||||
| DIP | DIP/RB | DIP | |||||||||||||||||||||||||||
| RB | |||||||||||||||||||||||||||||
| BIP | OP | OP | |||||||||||||||||||||||||||
| LIP | (LPD) | LIP | |||||||||||||||||||||||||||
| GIP | (HMF) | (HMF) | |||||||||||||||||||||||||||
UIP=usual interstitial pneumonia; DAD=diffuse alveolar damage; NSIP=non-specific interstitial pneumonia; DIP=desquamative interstitial pneumonia; RB=respiratory bronchiolitis; BIP=bronchiolitis obliterans interstitial pneumonia; OP=organizing pneumonia; LIP=lymphoid interstitial pneumonia; LPD=lymphoproliferative disease (not considered a diffuse lung disease); GIP=giant cell interstitial pneumonia; HMF=heavy metal fibrosis, no longer grouped with diffuse lung disease
Lymphoid interstitial pneumonia was originally included in this category, then excluded, then included again.[9]
參考文獻 编辑
- ^ Clinical infectious diseases : a practical approach. New York, NY [u.a.]: Oxford Univ. Press. 1999: 833 [2016-05-15]. ISBN 978-0-19-508103-9. （原始内容于2014-06-26）. Authors list列表中的
|first1=缺少|last1=(帮助) - ^ Nicholson AG. Classification of idiopathic interstitial pneumonias: making sense of the alphabet soup. Histopathology. November 2002, 41 (5): 381–91. PMID 12405906. doi:10.1046/j.1365-2559.2002.01421.x.
- ^ Flaherty KR, King TE, Raghu G, et al. Idiopathic interstitial pneumonia: what is the effect of a multidisciplinary approach to diagnosis?. Am. J. Respir. Crit. Care Med. October 2004, 170 (8): 904–10. PMID 15256390. doi:10.1164/rccm.200402-147OC.
- ^ Kim DS, Collard HR, King TE. Classification and natural history of the idiopathic interstitial pneumonias. Proc Am Thorac Soc. June 2006, 3 (4): 285–92. PMC 2658683 . PMID 16738191. doi:10.1513/pats.200601-005TK.
- ^ Leslie KO, Wick MR. Practical Pulmonary Pathology: A Diagnostic Approach. Elsevier Inc. 2005. ISBN 978-0-443-06631-3.
- ^ 6.0 6.1 American Thoracic, Society; European Respiratory, Society. American Thoracic Society/European Respiratory Society International Multidisciplinary Consensus Classification of the Idiopathic Interstitial Pneumonias. This joint statement of the American Thoracic Society (ATS), and the European Respiratory Society (ERS) was adopted by the ATS board of directors, June 2001 and by the ERS Executive Committee, June 2001. Am. J. Respir. Crit. Care Med. January 2002, 165 (2): 277–304. PMID 11790668. doi:10.1164/ajrccm.165.2.ats01.
- ^ Visscher DW, Myers JL. Histologic spectrum of idiopathic interstitial pneumonias. Proc Am Thorac Soc. June 2006, 3 (4): 322–9 [2016-05-15]. PMID 16738196. doi:10.1513/pats.200602-019TK. （原始内容于2019-12-11）.
- ^ Katzenstein AL, Myers JL. Idiopathic pulmonary fibrosis: clinical relevance of pathologic classification. Am. J. Respir. Crit. Care Med. 1998, 157 (4 Pt 1): 1301–15. PMID 9563754. doi:10.1164/ajrccm.157.4.9707039.
- ^ Swigris JJ, Berry GJ, Raffin TA, Kuschner WG. Lymphoid interstitial pneumonia: a narrative review. Chest. December 2002, 122 (6): 2150–64. PMID 12475860. doi:10.1378/chest.122.6.2150.