lymphoid interstitial pneumonia
Definition: LIP is a form of ?idiopathic? interstitial pneumonia.
Synopsis
dense and diffuse alveolar septal infiltrates associating lymphocytes, plasmocytes, plasmacytoid cells and macrophages
+/- multinucleated giant cells
+/- small ill-defined epithelioid granuloma
+/- interstitial fibrosis
+/- microscopic honeycomb remodeling
+/- BALT hyperplasia (pulmonary lymphoid hyperplasia)
Associations
- Pneumocystis jiroveci pneumonia
- Epstein-Barr virus infection
- HIV infection
- Legionella pneumonia
- tuberculosis
- Mycoplasma
- Chlamydia
hypersensitivity pneumonitis (extrinsic allergic alveolitis)
dysimmunity and auto-immunity (39%)
- Sjögren syndrome
- rheumatoid arthritis
- systemic lupus erythematosus
- Hashimoto thyroiditis
- myasthenia gravis
- pernicious anemia
- drug-associated lung injury
- toxin-associated lung injury
- bone marrow transplantation
- hypogammaglobulinemia
- celiac sprue
- primary biliary cirrhosis
immunodeficiency diseases (14%)
- HIV infection +/- DILS
- genetic immunodeficiency syndromes
- common variable immunodeficiency (CVID) (10607809)
- agammaglobulinemia
allogenic bone marrow transplantation (pulmonary GVHD)
drug reactions
pulmonary alveolar microlithiasis
Differential diagnosis
NSIP
low-grade lymproliferative disease
hypersensitivity pneumonitis
atypical mycobacterial infections
pulmonary drug reactions
See also
other pulmonary lymphoid hyperplasias
lymphoid pneumonitis
- nonspecific interstitial pneumonitis (NSIP)
References
Swigris JJ, Berry GJ, Raffin TA, Kuschner WG. Lymphoid interstitial pneumonia: a narrative review. Chest. 2002 Dec;122(6):2150-64. PMID: 12475860