Collard et al evaluated lung biopsies from patients with usual interstitial pneumonia (UIP). They identified features associated with a response to conventional therapy. The authors are from the University of California San Francisco, University of Colorado, National Jewish Medical and Research Center and the Mayo Clinic Scottsdale.


Conventional therapy: combination of corticosteroid and a cytotoxic agent


Outcome: change in forced vital capacity as percent of predicted at 6 months after starting therapy


Assessment: microscopic examination of an adequate lung biopsy


Histologic features associated with improved vital capacity:

(1) lymphoplasmacytic inflammation outside of areas of fibrosis


Histologic features associated with decreased vital capacity:

(1) organizing pneumonia (airspace organization)

(2) moderate or substantial fibroblast foci


Overall survival was not associated with histologic findings. It was worse if:

(1) The patient is older.

(2) The baseline forced vital capacity as percent of predicted is poor.


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