Desquamative interstitial pneumonia: A case report

Zhang,Hailong; Yu,Guohua; Yang,Ben; Ma,Shengyao; Wang,Yubing; Zhang,Xiaoqi; Zhang,Yong; Qu,Mei-Hua

doi:10.3892/etm.2024.12487

Desquamative interstitial pneumonia: A case report

Authors:
- Hailong Zhang
- Guohua Yu
- Ben Yang
- Shengyao Ma
- Yubing Wang
- Xiaoqi Zhang
- Yong Zhang
- Mei-Hua Qu
View Affiliations

Affiliations: Biopharmaceutical Laboratory, Key Laboratory of Shandong Province Colleges and Universities, School of Life Science and Technology, Weifang Medical University, Weifang, Shandong 261053, P.R. China, Department of Respiratory and Critical Care Medicine, Translational Medical Center, Weifang Second People's Hospital, Weifang Respiratory Disease Hospital, Weifang, Shandong 261041, P.R. China
Published online on: March 13, 2024 https://doi.org/10.3892/etm.2024.12487
Article Number: 199
Copyright: © Zhang et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

Diffuse cystic lung diseases (DCLDs) are a group of heterogeneous lung diseases that are characterized by inflated spaces or cysts within the lung parenchyma. They also exhibit similar imaging characteristics and clinical manifestations compared with those of cystic lesions, such as pulmonary cavities, emphysema, bronchiectasis and honeycomb lung. The most common DCLDs encountered in the clinic include lymphangioleiomyomatosis, Birt‑Hogg‑Dubé syndrome, Langerhans cell histiocytosis and lymphocytic interstitial pneumonia. In particular, accurate diagnosis of DCLDs in terms of the different lesions found is important, because their clinical courses, prognoses and treatment strategies vary widely. However, because DCLDs usually have overlapping clinical presentations, diagnosis typically requires a combination of clinical considerations that take into account characteristics of the cyst, its distribution, organ of origin and background parenchymal findings. The present report documents the case of a 73‑year‑old man diagnosed with desquamative interstitial pneumonia (DIP). The patient was admitted to the hospital due to chest tightness, shortness of breath and intermittent fever. The patient had been a smoker for >60 years and had stopped smoking for 6 months before being admitted. A transbronchial lung biopsy, bronchoscopy and alveolar lavage cytopathogen culture were performed to confirm the diagnosis of desquamative interstitial pneumonia (DIP). The patient was treated with hormonal therapy and advised to abstain from smoking. The diagnosis of DIP in comparison with other DCLDs was summarized for the purpose of providing a clinical basis for the accurate clinical diagnosis of DIP and the development of evidence‑based practice guidelines.

View Figures

View References

1	Panchabhai TS, Farver C and Highland KB: Lymphocytic interstitial pneumonia. Clin Chest Med. 37:463–474. 2016.PubMed/NCBI View Article : Google Scholar
2	Radzikowska E: Update on pulmonary Langerhans cell histiocytosis. Front Med (Lausanne). 7(582581)2021.PubMed/NCBI View Article : Google Scholar
3	Diken ÖE, Şengül A, Beyan AC, Ayten Ö, Mutlu LC and Okutan O: Desquamative interstitial pneumonia: Risk factors, laboratory and bronchoalveolar lavage findings, radiological and histopathological examination, clinical features, treatment and prognosis. Exp Ther Med. 17:587–595. 2019.PubMed/NCBI View Article : Google Scholar
4	Obaidat B, Yazdani D, Wikenheiser-Brokamp KA and Gupta N: Diffuse cystic lung diseases. Respir Care. 65:111–126. 2020.PubMed/NCBI View Article : Google Scholar
5	Ryu JH, Tian X, Baqir M and Xu K: Diffuse cystic lung diseases. Front Med. 7:316–327. 2013.PubMed/NCBI View Article : Google Scholar
6	Liebow AA, Steer A and Billingsley JG: Desquamative interstitial pneumonia. Am J Med. 39:369–404. 1965.PubMed/NCBI View Article : Google Scholar
7	Godbert B, Wissler MP and Vignaud JM: Desquamative interstitial pneumonia: An analytic review with an emphasis on aetiology. Eur Respir Rev. 22:117–123. 2013.PubMed/NCBI View Article : Google Scholar
8	Hino T, Lee KS, Yoo H, Han J, Franks TJ and Hatabu H: Interstitial lung abnormality (ILA) and nonspecific interstitial pneumonia (NSIP). Eur J Radiol Open. 8(100336)2021.PubMed/NCBI View Article : Google Scholar
9	Wells AU, Nicholson AG and Hansell DM: Challenges in pulmonary fibrosis. 4: Smoking-induced diffuse interstitial lung diseases. Thorax. 62:904–910. 2007.PubMed/NCBI View Article : Google Scholar
10	Blin T, De Muret A, Teulier M, Ferreira M, Vincent M, Catinon M, Legras A, Diot P and Marchand-Adam S: Desquamative interstitial pneumonia induced by metal exposure. A case report and literature review. Sarcoidosis Vasc Diffuse Lung Dis. 37:79–84. 2020.PubMed/NCBI View Article : Google Scholar
11	Serrano Gotarredona MP, Navarro Herrero S, Gómez Izquierdo L and Rodríguez Portal JA: Smoking-related interstitial lung disease. Radiologia (Engl Ed). 64 (Suppl 3):S277–S289. 2022.PubMed/NCBI View Article : Google Scholar
12	Moreno García MJ, López-Herce Cid J, Rodríguez Sánchez C, Alvarado Ortega F, Carrasco S and Ruza Tarrió F: Desquamative interstitial pneumonia. An Esp Pediatr. 23:431–437. 1985.PubMed/NCBI
13	Medenica M and Medenica M: Desquamative interstitial pneumonia with clinical, radiological and histologic correlation. Radiol Case Rep. 14:505–509. 2019.PubMed/NCBI View Article : Google Scholar
14	Yamakawa H, Suido Y, Sadoyama S, Yamanaka Y, Ikeda S, Kitamura H, Baba T, Okudela K, Takemura T and Ogura T: Desquamative interstitial pneumonia complicated with IgG4-related lung disease. Intern Med. 56:1553–1556. 2017.PubMed/NCBI View Article : Google Scholar
15	Margaritopoulos GA, Harari S, Caminati A and Antoniou KM: Smoking-related idiopathic interstitial pneumonia: A review. Respirology. 21:57–64. 2016.PubMed/NCBI View Article : Google Scholar
16	Hagmeyer L and Randerath W: Smoking-related interstitial lung disease. Dtsch Arztebl Int. 112:43–50. 2015.PubMed/NCBI View Article : Google Scholar
17	Lougheed MD, Roos JO, Waddell WR and Munt PW: Desquamative interstitial pneumonitis and diffuse alveolar damage in textile workers. Potential role of mycotoxins. Chest. 108:1196–1200. 1995.PubMed/NCBI View Article : Google Scholar
18	Nemery B: Metal toxicity and the respiratory tract. Eur Respir J. 3:202–219. 1990.PubMed/NCBI
19	Cottin V: Desquamative interstitial pneumonia: Still orphan and not always benign. Eur Respir Rev. 29(200183)2020.PubMed/NCBI View Article : Google Scholar
20	Lovrenski A, Eri Ž, Tegeltija D, Kašiković-Lečić S and Panjković M: Desquamative interstitial pneumonia: A case report. Srp Arh Celok Lek. 142:602–606. 2014.PubMed/NCBI View Article : Google Scholar
21	Ishimoto H, Sakamoto N, Ozasa M, Tsutsui S, Hara A, Kido T, Yamaguchi H, Yamamoto K, Obase Y, Ishimatsu Y and Mukae H: Idiopathic desquamative interstitial pneumonia diagnosed using transbronchial lung cryobiopsy: A case report. Respir Med Case Rep. 34(101523)2021.PubMed/NCBI View Article : Google Scholar
22	Sousa V and Carvalho L: DIP (desquamative interstitial pneumonia): As a tobacco-associated disease-case report. Rev Port Pneumol. 10:431–435. 2004.PubMed/NCBI View Article : Google Scholar : (In Portuguese).
23	Miyaoka M, Hatanaka K, Iwazaki M and Nakamura N: Pulmonary adenocarcinoma mimicking desquamative interstitial pneumonia: Report of 2 cases with genetic analysis. Int J Surg Pathol. 26:655–659. 2018.PubMed/NCBI View Article : Google Scholar
24	Neacşu F, Vârban AŞ, Simion G, Şurghie R, Pătraşcu OM, Sajin M, Dumitru M and Vrînceanu D: Lung cancer mimickers-a case series of seven patients and review of the literature. Rom J Morphol Embryol. 62:697–704. 2021.PubMed/NCBI View Article : Google Scholar
25	Furuya K, Yasumori K, Takeo S, Sakino I, Uesugi N, Momosaki S and Muranaka T: Lung CT: Part 1, mimickers of lung cancer-spectrum of CT findings with pathologic correlation. AJR Am J Roentgenol. 199:W454–W463. 2012.PubMed/NCBI View Article : Google Scholar
26	Batra K and Adams TN: Imaging features of idiopathic interstitial lung diseases. J Thorac Imaging. 38 (Suppl 1):S19–S29. 2023.PubMed/NCBI View Article : Google Scholar
27	American Thoracic Society; European Respiratory Society. American thoracic society/European respiratory society international multidisciplinary consensus classification of the idiopathic interstitial pneumonias. This joint statement of the American thoracic society (ATS), and the European respiratory society (ERS) was adopted by the ATS board of directors, June 2001 and by the ERS executive committee, June 2001. Am J Respir Crit Care Med. 165:277–304. 2002.PubMed/NCBI View Article : Google Scholar
28	Hellemons ME, Moor CC, von der Thüsen J, Rossius M, Odink A, Thorgersen LH, Verschakelen J, Wuyts W, Wijsenbeek MS and Bendstrup E: Desquamative interstitial pneumonia: A systematic review of its features and outcomes. Eur Respir Rev. 29(190181)2020.PubMed/NCBI View Article : Google Scholar
29	Craig PJ, Wells AU, Doffman S, Rassl D, Colby TV, Hansell DM, Du Bois RM and Nicholson AG: Desquamative interstitial pneumonia, respiratory bronchiolitis and their relationship to smoking. Histopathology. 45:275–282. 2004.PubMed/NCBI View Article : Google Scholar
30	Katzenstein AL, Mukhopadhyay S, Zanardi C and Dexter E: Clinically occult interstitial fibrosis in smokers: Classification and significance of a surprisingly common finding in lobectomy specimens. Hum Pathol. 41:316–325. 2010.PubMed/NCBI View Article : Google Scholar
31	Ryu JH, Colby TV, Hartman TE and Vassallo R: Smoking-related interstitial lung diseases: A concise review. Eur Respir J. 17:122–132. 2001.PubMed/NCBI View Article : Google Scholar
32	Vassallo R: Diffuse lung diseases in cigarette smokers. Semin Respir Crit Care Med. 33:533–542. 2012.PubMed/NCBI View Article : Google Scholar
33	Deutsch GH, Young LR, Deterding RR, Fan LL, Dell SD, Bean JA, Brody AS, Nogee LM, Trapnell BC, Langston C, et al: Diffuse lung disease in young children: Application of a novel classification scheme. Am J Respir Crit Care Med. 176:1120–1128. 2007.PubMed/NCBI View Article : Google Scholar
34	Jarrot PA, Mahmoudi R, Novella JL and Manckoundia P: Pneumonia due to Yersinia enterocolitica. Med Mal Infect. 43:38–39. 2013.PubMed/NCBI View Article : Google Scholar : (In French).
35	He H and Wunderink RG: Staphylococcus aureus pneumonia in the community. Semin Respir Crit Care Med. 41:470–479. 2020.PubMed/NCBI View Article : Google Scholar
36	Radzikowska E: Pulmonary Langerhans' cell histiocytosis in adults. Adv Respir Med. 85:277–289. 2017.PubMed/NCBI View Article : Google Scholar
37	Shaw B, Borchers M, Zander D and Gupta N: Pulmonary Langerhans cell histiocytosis. Semin Respir Crit Care Med. 41:269–279. 2020.PubMed/NCBI View Article : Google Scholar
38	Xu KF, Xu W, Liu S, Yu J, Tian X, Yang Y, Wang ST, Zhang W, Feng R and Zhang T: Lymphangioleiomyomatosis. Semin Respir Crit Care Med. 41:256–268. 2020.PubMed/NCBI View Article : Google Scholar
39	McCarthy C, Gupta N, Johnson SR, Yu JJ and McCormack FX: Lymphangioleiomyomatosis: Pathogenesis, clinical features, diagnosis, and management. Lancet Respir Med. 9:1313–1327. 2021.PubMed/NCBI View Article : Google Scholar
40	Pitt J: Lymphocytic interstitial pneumonia. Pediatr Clin North Am. 38:89–95. 1991.PubMed/NCBI View Article : Google Scholar
41	Daccord C, Good JM, Morren MA, Bonny O, Hohl D and Lazor R: Birt-Hogg-Dubé syndrome. Eur Respir Rev. 29(200042)2020.PubMed/NCBI View Article : Google Scholar