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Volume 134, Issue 1, Pages (July 2008)

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1 Volume 134, Issue 1, Pages 126-132 (July 2008)
Role of Surgical Lung Biopsy in Separating Chronic Hypersensitivity Pneumonia From Usual Interstitial Pneumonia/Idiopathic Pulmonary Fibrosis*: Analysis of 31 Biopsies From 15 Patients  Syvain Trahan, MD, Viktor Hanak, MD, Jay H. Ryu, MD, Jeffrey L. Myers, MD  CHEST  Volume 134, Issue 1, Pages (July 2008) DOI: /chest Copyright © 2008 The American College of Chest Physicians Terms and Conditions

2 Figure 1 Low-magnification photomicrograph (original magnification × 40) showing chronic bronchiolitis in a patient with HP. There is a peribronchiolar infiltrate of predominantly lymphocytes in this field with minimal associated fibrosis. CHEST  , DOI: ( /chest ) Copyright © 2008 The American College of Chest Physicians Terms and Conditions

3 Figure 2 Chronic bronchiolitis with granulomatous inflammation in a patient with HP. Top: Intermediate-magnification photomicrograph (original × 100) showing chronic bronchiolitis in which the peribronchiolar interstitium is expanded by an inflammatory infiltrate in which mononuclear cells predominate with occasional associated giant cells. Bottom: High-magnification photomicrograph (original × 400) showing an isolated multinucleated giant cell illustrated in the top panel. The cytoplasm contains a calcified Schaumann body, a nonspecific finding. CHEST  , DOI: ( /chest ) Copyright © 2008 The American College of Chest Physicians Terms and Conditions

4 Figure 3 Low-magnification photomicrograph (original × 20) showing a cellular interstitial pneumonia in which the findings are accentuated around distal bronchioles (*). CHEST  , DOI: ( /chest ) Copyright © 2008 The American College of Chest Physicians Terms and Conditions

5 Figure 4 High-magnification photomicrograph (original × 200) showing subepithelial fibroblast foci (arrows) in HP that are unassociated with honeycomb change, significant fibrosis, or organizing pneumonia. CHEST  , DOI: ( /chest ) Copyright © 2008 The American College of Chest Physicians Terms and Conditions


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