ILD

• related: Pulmonology

ILD aka Diffuse Parenchymal Lung Disease major types:

• idiopathic interstitial pneumonia (IIP)
• Interstitial Pneumonia with Autoimmune Features (IPAF)
• connective tissue disease related (CTD-ILD)
  • scleroderma (can also have UIP)
  • RA
  • sjogren
  • myositis
• drug related
• granulomatous: sarcoidosis
• others
  • HIV
  • LAM, HX

IIP

First do HR CT scan. Types:

• UIP
  • honeycombing, LL and peripheral dominant
  • +- ground glass
  • reticular + traction bronchiectasis
• NSIP
  • no honeycombing
  • ground glass
  • diffused, subpleural sparing
• BR-ILD
  • smoking hx
  • central lobular nodules
  • traction bronchiectasis
• Misc
  • desquamative interstitial pneumonia (DIP)
    • end stage, severe BR-ILD
  • acute interstitial pneumonia (AIP)
    • acute/subacute, rapid few months
    • ARDS looking
    • atoll sign or reverse halo sign
    • really sick
    • treat with steroids
  • cryptogenic organizing pneumonia (COP)
    • migratory
    • consolidative ground glass

subpleural sparing:

reverse halo sign:

graph LR
id1[Diffuse Parenchymal Lung Disease]-->id2["DPLD of known cause (drugs) or association (collagen, vascular disease)"]
id1-->id3[Idiopathic interstial pneumonias]
id1-->id4[Granulomatous DPLD, eg sarcoidosis]
id1-->id5[Other forms, eg LAM, HX]

graph TB
id3[Idiopathic interstial pneumonias]-->id6[Idiopathic pulmonary fibrosis] & id7[IIP other than IPF]
id7-->id8[DIP] & id9[AIP] & id10[NSIP] & id11[Cryptogenic] & id12[LIP] & id13[respiratory bronchiolitis ILD]