| Summary: | Introduction. Desquamative interstitial pneumonia is one of the rarest
idiopathic interstitial pneumonias and the rarest form of smoking-related
interstitial lung diseases. It was first described by Liebow in 1965.
Histologically, it is characterized by the presence of eosinophilic
macrophages uniformly filling airspaces which often contain a finely granular
light-brown pigment that does not stain for hemosiderin. The alveolar walls
are usually mildly thickened by fibrous tissue and infiltrated by a moderate
number of lymphocytes. Case Outline. Our patient was a 56-year-old male,
heavy smoker, with bilateral lung infiltrations of unknown etiology and
several months of discomfort in the form of dry cough and shortness of
breath. Lung function tests showed a moderate restrictive ventilation
disorder and a severe reduction of diffusing capacity. Since bronchoscopic
specimens did not reveal lung lesion etiology, an open lung biopsy of the
lower left pulmonary lobe was performed, and based on the obtained surgical
material the pathohistologically diagnosis of desquamative interstitial
pneumonia was established. The patient was started on corticosteroid and
immunosuppressive therapy, and he ceased smoking. At the last control
examination, two years after the onset of symptoms, the patient was feeling
well, and high-resolution computed tomography (HRCT) scan of the thorax
showed regression of pathological changes. Conclusion. Although, as in our
case, the majority of DIP patients improve on treatment, some patients still
develop progressive irreversible fibrosis despite therapy.
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