A pulmonologist is reviewing surgical lung biopsy reports for four different adult patients, all of whom presented with progressive exertional dyspnea and bilateral interstitial opacities on high-resolution computed tomography. In order to establish the correct clinical diagnosis and formulate an appropriate management plan, the specific histopathological pattern must be correlated with the corresponding disease entity. Match each histopathological biopsy description with its definitive clinical diagnosis.
- Temporally heterogeneous, patchy interstitial fibrosis with fibroblastic foci and subpleural honeycombingIdiopathic pulmonary fibrosis
- Temporally uniform, spatially homogeneous interstitial cellular inflammation and fibrosis lacking honeycomb changeNonspecific interstitial pneumonia
- Diffuse accumulation of pigmented macrophages filling alveolar spaces with mild septal thickeningDesquamative interstitial pneumonia
- Well-formed non-caseating granulomas distributed in a perilymphatic pattern along bronchovascular bundlesPulmonary sarcoidosis
Answer
Temporally heterogeneous fibrosis matches Idiopathic pulmonary fibrosis; Temporally uniform fibrosis matches Nonspecific interstitial pneumonia; Diffuse accumulation of pigmented macrophages matches Desquamative interstitial pneumonia; Non-caseating granulomas in a perilymphatic pattern matches Pulmonary sarcoidosis.
Each histopathological description corresponds to a distinct interstitial lung disease: UIP's temporal heterogeneity pairs with Idiopathic Pulmonary Fibrosis; uniform cellular/fibrotic changes pair with Nonspecific Interstitial Pneumonia; smoker's macrophages in alveoli pair with Desquamative Interstitial Pneumonia; and perilymphatic granulomas pair with Sarcoidosis.
Step-by-Step Solution
Key Concept
Histopathological differentiation of interstitial lung diseases