Nonspecific Interstitial Pneumonia: Variable Appearance at High-Resolution Chest CT

PURPOSE: To describe the computed tomographic (CT) findings in patients with nonspecific interstitial pneumonia (NSIP) and to compare these with the CT findings of other chronic infiltrative lung diseases.

MATERIALS AND METHODS: Findings in 50 patients with biopsy–proved NSIP and a CT scan were reviewed by two thoracic radiologists in consensus. After the findings were described, the observers judged whether the findings were compatible with previously published descriptions of NSIP or whether the findings would support the diagnosis of a different chronic infiltrative lung disease.

RESULTS: Eleven (22%) of the 50 patients had CT findings that were compatible with previous descriptions of NSIP. Sixteen (32%) patients had CT findings that were more compatible with usual interstitial pneumonia. The other 23 (46%) patients had findings that were nondiagnostic or most compatible with the diagnosis of another chronic infiltrative lung disease.

CONCLUSION: Contrary to previously published articles, there are a wide variety of CT findings in cases of NSIP.

References

  • 1 Katzenstein AL, Fiorelli RF. Nonspecific interstitial pneumonia/fibrosis: histologic features and clinical significance. Am J Surg Pathol 1994; 18:136-147. Crossref, MedlineGoogle Scholar
  • 2 Park JS, Lee KS, Kim JS, et al. Nonspecific interstitial pneumonia with fibrosis: radiographic and CT findings in seven patients. Radiology 1995; 195:645-648. LinkGoogle Scholar
  • 3 Kim TS, Lee KS, Chung MP, et al. Nonspecific interstitial pneumonia with fibrosis: high-resolution CT and pathologic findings. AJR Am J Roentgenol 1998; 171:1645-1650. Crossref, MedlineGoogle Scholar
  • 4 Johkoh T, Müller NL, Cartier Y, et al. Idiopathic interstitial pneumonias: diagnostic accuracy of thin-section CT in 129 patients. Radiology 1999; 211:555-560. LinkGoogle Scholar
  • 5 Hartman TE, Primacy SL, Swensen SJ, Hansell D, McGuinness G, Müller NL. Desquamative interstitial pneumonia: thin-section CT findings in 22 patients. Radiology 1993; 187:787-790. LinkGoogle Scholar
  • 6 Holt RM, Schmidt RA, Godwin JD, Raghu G. High resolution CT findings in respiratory bronchiolitis associated interstitial lung disease. J Comput Assist Tomogr 1993; 17:46-50. Crossref, MedlineGoogle Scholar
  • 7 Ryu JH, Myers JL, Mu’adhdhin DE, Douglas WW. Non-specific interstitial pneumonia. Clin Pulm Med 1998; 5:104-108. CrossrefGoogle Scholar
  • 8 Carrington CB, Gaensler EA, Coutu RE, et al. Natural history and treated course of usual and desquamative interstitial pneumonia. N Engl J Med 1978; 298:801-809. Crossref, MedlineGoogle Scholar
  • 9 Katzenstein AL, Myers JL, Prophet WD, Corley LS, III, Shin MS. Bronchiolitis obliterans and usual interstitial pneumonia: a comparative clinicopathologic study. Am J Surg Pathol 1986; 10:378-381. Google Scholar
  • 10 Guerry-Force ML, Müller NL, Wright JL, et al. A comparison of bronchiolitis obliterans with organizing pneumonia, usual interstitial pneumonia, and small airways disease. Am Rev Respir Dis 1987; 135:705- 712. MedlineGoogle Scholar
  • 11 Bjoraker JA, Ryu JH, Edwin MK, et al. Prognostic significance of histopathologic subsets in idiopathic pulmonary fibrosis. Am J Respir Crit Care Med 1998; 157:199-203. Crossref, MedlineGoogle Scholar
  • 12 Katzenstein AL, Myers JL. Idiopathic pulmonary fibrosis: clinical relevance of pathologic classification. Am J Respir Crit Care Med 1998; 157:1301-1315. Crossref, MedlineGoogle Scholar

Article History

Published in print: Dec 2000