Update der idiopathischen interstitiellen Pneumonien

Zusammenfassung

Die revidierte Konsensusklassifikation der idiopathischen interstitiellen Pneumonien (IIP) beinhaltet wichtige Neuerungen. Zunächst wurde der Stellenwert einer multidisziplinären Diagnostik gestärkt, sodass die Diagnose der IIP regelhaft von Pneumologen, Radiologen und Pathologen gemeinsam gestellt werden sollte. Darüber hinaus wurde die Definition der nicht spezifischen interstitiellen Pneumonie spezifiziert. Häufige, seltene und unklassifizierbare Entitäten wurden definiert; wobei die häufigen IIP in chronisch fibrosierende, raucherassoziierte und akut/subakute Erkrankungen unterteilt werden. Neue Entitäten (idiopathische pleuroparenchymatöse Fibroelastose) bzw. seltene histopathologische Muster (akute fibrinöse und organisierende Pneumonie, zentrilobuläre Fibrose/bronchiolozentrisches Muster bei IIP) wurden in die revidierte Klassifikation aufgenommen. Darüber hinaus wurden Algorithmen zum klinischen Management von Mischformen bzw. unklassifizierbaren IIP formuliert.

Abstract

The consensus classification of the idiopathic interstitial pneumonias (IIP) has recently been updated. Importantly, the multidisciplinary approach to diagnosis including clinicians, radiologists and pathologists has been strengthened. Furthermore, nonspecific interstitial pneumonia is now defined as a distinct entity. IIP are divided into chronic-fibrosing, smoking-related and acute/subacute disorders. Novel entities (idiopathic pleuroparenchymal fibroelastosis) and rare histopathologic patterns (acute fibrinous and organizing pneumonia and interstitial pneumonia with bronchiolocentric distribution) are recognized. In addition, the revised classification includes algorithms for the management of mixed forms or unclassifiable IIP.

Keywords

Usual interstitial pneumonia - nonspecific interstitial pneumonia - desquamative interstitial pneumonia - cryptogenic organizing pneumonia - acute interstitial pneumonia - lymphoid interstitial pneumonia

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