Idiopathic Pulmonary Fibrosis - Histology/Pathology

Histology/Pathology

Histologic specimens for the diagnosis of IPF must be large enough that the pathologist can comment on the underlying lung architecture. Small biopsies, such as those obtained via transbronchial lung biopsy (performed during bronchoscopy) are usually not sufficient for this purpose. Hence, larger biopsies obtained surgically via a thoracotomy or thoracoscopy are usually necessary.

The histological appearance associated with IPF is referred to as usual interstitial pneumonia (UIP). Although a pathologic diagnosis of UIP often corresponds to a clinical diagnosis of IPF, it can be seen in other diseases as well. Key features of UIP include interstitial fibrosis in a "patchwork pattern", interstitial scarring, honeycomb changes and fibroblast foci. There is usually only a relatively mild or minor component of interstitial chronic inflammation.