pulmonary disorders
Desquamative Interstitial Pneumonia
Introduction
Desquamative interstitial pneumonia is chronic lung inflammation characterized by mononuclear cell infiltration of the airspaces; it occurs almost exclusively in current or former cigarette smokers. Desquamative interstitial pneumonia is a type of Overview of Idiopathic Interstitial Pneumonias . The vast majority of adult patients with desquamative interstitial pneumonia are people who smoke, who tend to develop the disease in their 30s or 40s. The disease tends to affect the lung parenchyma uniformly. The alveolar walls are lined with plump cuboidal pneumocytes; there is moderate infiltration of the alveolar septum by lymphocytes, plasma cells, and, occasionally, eosinophils. Alveolar septal fibrosis, if present, is mild. The most striking feature is the presence of numerous pigmented macrophages within distal airspaces, mistaken as desquamated pneumocytes when the disease was first described. Honeycombing is rare. Similar but much less extensive findings occur in Respiratory Bronchiolitis–Associated Interstitial Lung Disease (RBILD), leading to the suggestion that desquamative interstitial pneumonia and RBILD are different manifestations of the same disease caused by cigarette smoking. Desquamative interstitial pneumonia manifests with gradually increasing dyspnea and nonproductive cough. 