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Interstitial lung disease: progress and problems

Correspondence to:
Correspondence to:
Dr S J Bourke
Department of Respiratory Medicine, Royal Victoria Infirmary, Newcastle upon Tyne NE1 4LP, UK; Stephen.Bourke{at}nuth.northy.nhs.uk

Interstitial lung disease involves all areas of medicine as it often occurs in patients with comorbidities or as a consequence of systemic diseases and their treatment. Typically the physician is faced with a breathless patient, a diffusely abnormal chest radiograph, and a wide differential diagnosis. Progress has been made in using high resolution computed tomography as the key investigation in characterising the pattern and extent of the disease. Bronchoalveolar lavage is particularly important in excluding infection as a cause of diffuse lung infiltrates. Surgical lung biopsies have led to a new classification system for the range of histopathological patterns of disease that were previously known by the collective term cryptogenic fibrosing alveolitis. Problems persist in deciding when a surgical lung biopsy is clinically justified, in understanding the pathogenesis of these diseases, and in finding more effective treatments.

Abbreviations: ILD, interstitial lung disease; IPF, idiopathic pulmonary fibrosis; UIP, usual interstitial pneumonia; NSIP, non-specific interstitial pneumonia; DIP, desquamative interstitial pneumonia; COP, cryptogenic organising pneumonia; EAA, extrinsic allergic alveolitis; BAL, bronchoalveolar lavage

Keywords: idiopathic pulmonary fibrosis; diffuse parenchymal lung disease; alveolitis

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