Visscher Daniel W, Myers Jeffrey L
Division of Anatomic Pathology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
Proc Am Thorac Soc. 2006 Jun;3(4):322-9. doi: 10.1513/pats.200602-019TK.
Histopathologic classification plays a key role in separating multiple forms of idiopathic interstitial pneumonia into clinically meaningful categories with important differences in natural history, prognosis, and treatment. Microscopic criteria in diagnosis of these entities include the pattern and microanatomic distribution of inflammation, fibroblast proliferation, collagen deposition, and architectural remodeling. Usual interstitial pneumonia (UIP) defines idiopathic pulmonary fibrosis and is the most common of the idiopathic interstitial pneumonias. UIP has distinctive morphologic features that allow precise diagnosis in classical cases. Other forms of idiopathic interstitial pneumonia include desquamative interstitial pneumonia, respiratory bronchiolitis-associated interstitial lung disease, acute interstitial pneumonia, and nonspecific interstitial pneumonia. These latter categories differ from UIP in that the histopathologic findings do not, by themselves, allow specific diagnosis in most cases and require careful correlation with clinical and radiologic findings.
组织病理学分类在将多种特发性间质性肺炎形式分为具有自然史、预后和治疗方面重要差异的临床有意义类别中起着关键作用。这些实体诊断的微观标准包括炎症的模式和微观解剖分布、成纤维细胞增殖、胶原沉积和结构重塑。普通型间质性肺炎（UIP）定义了特发性肺纤维化，是最常见的特发性间质性肺炎。UIP具有独特的形态学特征，可在典型病例中进行精确诊断。其他形式的特发性间质性肺炎包括脱屑性间质性肺炎、呼吸性细支气管炎相关间质性肺疾病、急性间质性肺炎和非特异性间质性肺炎。后几类与UIP的不同之处在于，组织病理学发现本身在大多数情况下不能进行特异性诊断，需要与临床和放射学发现仔细关联。
