Although nonspecific interstitial Pneumonia(NSIP) has recently been proposed as a histologic subtype of idiopathic interstitial pneumonia(IIP), a broad spectrum of clinicopathologic findings and a variable prognosis are less well characterized. In particular, it is less clear how NSIP relates to usual interstitial pneumonia (UIP). the aim of this study was to investigate the clinicopathologic features and prognosis of NSIP, and its differential diagnosis from UIP.
We analyzed the clinical, pathological findings and follow-up information of 21 NSIP patients and 18 UIP patients with biopsy-proven by open or video-assisted thoracoscopic lung biopsy.
NSIP was more often appeared in female and the clinical manifestations were nonspecific. High-resolution computed tomography (HRCT) demonstrated ground-glass, net and patchy attenuation in lung. Semiquantitative HRCT showed that the median fibrosis score in NSIP was found to be 3 (rang, 0 to 7) compared with 5 (rang, 2 to 7) in UIP (p<0.01). Pathological characteristic showed a heterogeneous appearance. According to pathological characteristic, NSIP was separated into cellar and fibrosing patterns. The cellar NSIP, fibrosing NSIP and UIP had a mean age of 41,50 and 59, respectively. The frequencies of Fibroblast foci, muscle sclerosis, honeycombing change and pulmonary architectural destruction of NSIP and UIP were 26.2% and 100% (P< 0.001), 35.6% and 81.2% (P< 0.05), 28.4% and 85.8% (P< 0.001), 42.9% and 100% (P<0.05), respectively. A response to glucocorticoid and a prognosis was significantly better in NSIP than in UIP.
NSIP was not easily differential from UIP in the general clinical manifestations. HRCT was helpful for the differential diagnosis of cellar NSIP and UIP. The definite diagnosis of idiopathic interstitial pneumonia was depended on open lung biopsy.
Open lung biopsy was very important in diagnosis of interstitial lung disease.
Li Xia, None.