Clinics in chest medicine
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Clinics in chest medicine · Dec 2004
ReviewThe role of bronchoalveolar lavage in interstitial lung disease.
Considerable progress has been made in understanding the similarities and differences among the forms of the interstitial lung diseases (ILDs), particularly the forms of idiopathic interstitial pneumonia, now recognized as distinct clinicopathologic entities. Lung parenchymal evaluation by high-resolution CT scanning of the chest may provide images that are virtually diagnostic of certain forms of ILD, but other testing, including bronchoalveolar lavage (BAL) and lung biopsy, may be required for accurate diagnosis. The differential diagnosis of these disorders rests on the clinician's interpretation of the clinical presentation and physical examination findings, pulmonary function testing, radiographic imaging, and, if required, sampling of lung tissue. This discussion examines the usefulness of BAL in the diagnosis of specific forms of ILD.
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Cryptogenic organizing pneumonia is a rare, distinct disorder that is sufficiently different from the other diseases in the group of idiopathic interstitial pneumonias to be designated as a separate entity. In its most typical presentation, it is characterized by dyspnea and cough, with multiple patchy alveolar opacities on pulmonary imaging. ⋯ No cause (as infection, drug reaction, or associated disease as connective tissue disease) is found. Corticosteroid treatment is rapidly effective, but relapses are common on reducing or stopping treatment.
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Clinics in chest medicine · Dec 2004
ReviewRespiratory bronchiolitis associated with interstitial lung disease and desquamative interstitial pneumonia.
This article explores issues of the diagnosis and management of respiratory bronchiolitis, respiratory bronchiolitis-associated interstitial lung disease, and desquamative interstitial pneumonia. These three diseases have common and overlapping features and sometimes are viewed as a continuum of smoking-induced disease, rather than as distinct and separate entities.