Interstitial Lung Disease Series-Part 2- Non specific Interstitial Pneumonia

ILD is one of the most difficult topics for the residents to understand. We have put together simple series with points to remember for each type. We agree, it is highly controversial and our points are comprehensive and may need revision periodically.  All we are offering are some typical things to remeber and pictures and this in no way is exhaustive and conclusive. This is the second case in the series.
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Main Contributor- Dr MGK Murthy.
Edited and Series Concept by Sumer Sethi

There are 6 types of Idiopathic Interstitial Pneumonias, also called interstitial lung disease. We will present six posts in this series called as Interstitial Lung Disease Series.

Case Number-2

Non specific Interstitial Pneumonia- second commonest amongst pulmonary fibrosis, just after Usual Interstitial Pneumonia

Note:  symmetric lower lobe involvement(typical), Relative subpleural sparing,  groundglass opacities, peribronchovascular fibrosis, mild reticular abnormalities, and traction bronchiectasis prominent

Golden Point 
Ground-glass abnormality is a common finding in many diffuse lung diseases, including all of the IIPs except UIP . Therefore, although its presence cannot help one make the diagnosis of NSIP, the absence of ground-glass abnormality can steer one toward a diagnosis of UIP, even if no honeycombing is present.

Short Note on Non specific Interstitial Pneumonia

Non smoking Women(40 to50yr)
Relatively  short  history
CXR- BLZ reticular and patchy opacities  rarely unilateral   D/D eosinophilic pneumonia    
HRCT- Bilateral patchy groundglass, irregular lines, bronchial dilatation                                                                                                                                            
Treatment- Steroids                                                      
Mortality- <10% in 5 yrs