title: Lymphoid interstitial pneumonia: clinicopathological and immunopathological findings in 18 cases.
abstract: Eighteen patients with lymphoid interstitial pneumonia (LIP) were studied. The diagnosis was established by the microscopic finding of interstitial infiltrates of lymphocytes and plasma cells. Forty-seven% of patients also had germinal centres, while 72% showed interstitial giant cells. Cases studied by the immunoperoxidase technique showed the interstitial plasma cells to be polytypic. The median age of patients was 56 years; most had cough, dyspnea, or chest pain. Chest X-rays showed either patchy interstitial infiltrates (usually bilateral) or poorly defined nodules. Ten patients had hypergammaglobulinemia; one had hypogammaglobulinemia. Two patients had Sjögren's syndrome, two had biopsy-proven chronic active hepatitis, and two had a clinical diagnosis of primary biliary cirrhosis. Follow-up examination of 14 patients showed clearing of symptoms, X-ray infiltrates or stable infiltrates in 4 cases each. Five patients died (mean survival, 41 months), one of whom succumbed to disseminated lymphoma and a second to respiratory failure. Our results support the hypothesis that LIP is a non-neoplastic cellular proliferation in which lymphoma may supervene. The high incidence (22%) of chronic liver disease has not previously been noted.
authors.affiliation: Los Angeles County--University of Southern California Medical Center.
authors.forename: M N
authors.initials: MN
authors.lastname: Koss
authors.forename: L
authors.initials: L
authors.lastname: Hochholzer
authors.forename: J M
authors.initials: JM
authors.lastname: Langloss
authors.forename: W D
authors.initials: WD
authors.lastname: Wehunt
authors.forename: A A
authors.initials: AA
authors.lastname: Lazarus
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008214:Lymphocytes / Q000276:immunology / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011658:Pulmonary Fibrosis / Q000175:diagnosis / Q000276:immunology / Q000473:pathology*