Tuberc Respir Dis.  2009 Jul;67(1):37-41.

A Case of Lymphocytic Interstitial Pneumonia Manifested as a Multi-focal Consolidation

• Hwang KS
• Roh YW
• Song SH
• Kim SH
• Sohn JW
• Yoon HJ
• Shin DH
• Park SS
• Oh YH
• Kim TH

Abstract

Lymphocytic interstitial pneumonia (LIP) is a rare disorder characterized by a diffuse infiltration of the alveolar space, interstitium by lymphocytes, plasma cells, and reticuloendothelial cells. Although its etiology is unknown, LIP has been associated with autoimmune disorders and with viral infections. Because it's clinical and radiographic features are nonspecific, a confirmatory diagnosis is performed by open lung biopsy. A 59-year-old female presented dry cough, which had been present for 1 month. On initial findings of multifocal consolidation at the right middle lobe on both lower lobes in chest radiography, the first diagnosis of cryptogenic organizing pneumonia was suggested. On open lung biopsy, LIP was diagnosed. The patient had no autoimmune disease, viral infection or monoclonal gammopathy. After 3 months of corticosteroid treatment, the patient experienced improved symptoms, reduced abnormalities on chest radiography, and improved pulmonary function testing.

Keyword

Lymphocytic interstitial pneumonia; Cryptogenic organizing pneumonia; Interstitial lung disease

MeSH Terms

Autoimmune Diseases
Biopsy
Cough
Cryptogenic Organizing Pneumonia
Female
Humans
Lip
Lung
Lung Diseases, Interstitial
Lymphocytes
Middle Aged
Paraproteinemias
Plasma Cells
Respiratory Function Tests
Thorax

Figure

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  Figure 1 Chest X-ray on admission shows bilateral, multifocal consolidations and bilateral pleural effusion (A). After 3 months with steroid treatment, chest X-ray shows marked improvement (B).

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  Figure 2 High resolution computed tomography of chest on admission shows consolidation at right middle lobe (A) and multifocal ground grass opacity at both lower lobes (B). After 3 months with steroid treatment, marked improvement observed (C, D).

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  Figure 3 Histopathologic finding of the resected lung. Right lower lobe revealed lymphoid infilatration in the peribronchial, interstitial and alveolar septum (A, H&E stain, ×2). Immunohistochemical stains for CD3, CD20 revealed polyclonal lymphocytes (B, CD3 stain, ×2; C, CD20 stain, ×2).

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