The interstitial lung diseases: a pathologist's view.

The accurate diagnosis of the interstitial lung diseases requires that the pathologic features, whether they be derived from routine light microscopy, bronchoalveolar lavage material, ultrastructural or immunologic studies, be interpreted in the light of the clinical, roentgenographic, and physiologic presentations. The clinician must ensure that representative tissue is sampled and that the pertinent clinical data are supplied to the pathologist. Furthermore, the clinician should gain some appreciation of the pathologic changes commonly encountered. Such knowledge facilitates clinicopathologic correlations. The pathologist must ensure that the sampled tissue is handled in the most appropriate and efficient manner in order to realize the greatest diagnostic yield. In addition, the pathologist must convey to the clinician his confidence in the diagnosis as to whether the observed pathologic changes are diagnostically specific or nonspecific, in light of the clinical data. The diagnosis of interstitial disease in the immunocompromised patient entails even more intensive efforts, which must be accomplished in a very limited period of time. Only the close cooperation between clinician and pathologist can ensure diagnostic success.