[Atypical adenomatous hyperplasia and dysplasia in squamous epithelium of the honeycomb lung in outcome of idiopathic fibrosing alveolitis].

Relationships between sclerosis and carcinogenesis in the honeycomb lung were studied in the outcome of two variants of idiopathic fibrosing alveolitis (IFA)-common interstitial pneumonia (CIP) and desquamative interstitial pneumonia (DIP) which may be a background for lung carcinoma development. The material was obtained from 43 patients with the diagnosis of IFA. Immunohistochemically were studied: TNF-alpha (DAKO, Denmark, 1:100), pancytokeratines (Immunotech, Germany, concentration 1:100), Ki67 (DAKO, Denmark, 1:40), TGF-beta (Biosource international, USA, 1:100), CD34 (Novocastra, Great Britain, 1:100), EMA (DAKO, Denmark, 1:100). Differences in morphogenesis of CIP and DIP were found. CIP is characterised by primary pronounced lung interstitium damage with stroma vascularisation already at early stages with secondary involvement of the epithelium with development of adenomatous hyperplasia with or without atypia which is usually observed at the stage of lung honeycomb. Pronounced primary damage of alveolar epithelium as a result of action of activated alveolar macrophages with subsequent proliferation, desquamation and squamous epithelium metaplasia were more typical for DIP. The presence of squamous meta- and dysplasia of the epithelium is characteristic for DIP outcome in the honeycomb lung.