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Nonspecific Interstitial Pneumonia (NSIP)

by Carlo Raj, MD
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    00:00 Nonspecific interstitial pneumonia, what is this? Well for the most part, it's the histopathologic process associated with many of your connective tissue diseases or disorders What is this referring to? SLE being the most common.

    00:15 Okay, so everything that we're doing here, with any autoimmune or connective tissue disease is then causing damage to the lung Where most likely? interstitial.

    00:24 We will then call this histopathologically what? nonspecific.

    00:29 Okay, SLE being the most common, also seen in individuals with autoantibodies in general but not clearly defined as being connective tissue disease but notice such so some of these that we'll take a look at in this lecture series are issues such as SLE.

    00:44 So what does that mean to you in terms of labs? Oh, positive ANA. Oh, positive anti-Smith which is a little bit more specific Seen also in drug-induced.

    00:55 if there is a patient that requires an anti-neoplastic, or whatnot.

    00:59 and at this point goes on to develop a restrictive lung disease type, then this will be more or less your nonspecific type of findings More frequent in younger patients, females compared to usual interstitial pneumonitis That usual interstitial pneumonitis was the pathologic diagnosis that you found with Idiopathic pulmonary fibrosis which is a chronic type of fibrosis, more frequent in younger patients, more commonly steroid-responsive than UIP Rememeber in chronic fibrosis, you'll have many of those underlying disorders that you might have and recurrent, recurrent , recurrent bouts and damage to the lung resulting in fibrosis. And with that type of fibrosis, very unlikely that it will then respond to an anti-inflammatory.

    01:46 However if it's a nonspecific type, well you'd find maybe a little bit of curbing of the symptoms of a patient upon administration of steroids Now, what are we looking at here histopathologically? Pay attention.

    02:00 The path shows patchy inflammation however, you do not have the abundance of fibroblast like we had seen with usual interstitial pneumonitis.

    02:13 Once again, in usual interstitial pneumonitis, idiopathic pulmonary fibrosis clinically is what it's diagnosed as.

    02:21 Know both.

    02:22 You would find lots of fibrosis deposition hence we talked about the honeycomb We also referred to well fibroblast coming in laying down that collagen here however, if it's nonspecific interstitium, understand that you'd find patchy type of inflammation overall however you will not find fibroblast, we'll have some areas of normal lung, in fact.


    About the Lecture

    The lecture Nonspecific Interstitial Pneumonia (NSIP) by Carlo Raj, MD is from the course Restrictive Lung Disease.


    Included Quiz Questions

    1. NSIP commonly more responsive to steroids than UIP.
    2. UIP is more common in women than NSIP.
    3. NSIP has a worse prognosis than UIP.
    4. NSIP usually progresses more rapidly than UIP.
    5. UIP more commonly presents with an obstructive pattern, while NSIP is more commonly a restrictive pattern.
    1. Systemic lupus erythematosis.
    2. Aspiration pneumonia.
    3. Bronchiolitis obliterans.
    4. CREST syndrome.
    5. Hemochromatosis.

    Author of lecture Nonspecific Interstitial Pneumonia (NSIP)

     Carlo Raj, MD

    Carlo Raj, MD


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