Case Quick Facts:

  • Mean age: 52-56 yrs
  • Associated with Sj√∂gren syndrome (MC), systemic lupus erythematosus, amyloidosis, HIV (peds)
  • Shown above on CT: thin-walled cysts, midlung-basilar gradient
  • Rx: corticosteroids

Credit: Case submitted by Dr. Tan-Lucien Mohammed (@TLHM_MD – Follow on Twitter!)

More detailed discussion on LIP as follows including findings seen on multiple modalities:

Lymphocytic interstitial pneumonia (LIP) is a rare and potentially severe form of interstitial lung disease that is characterized by infiltration of lymphocytes into the interstitial tissue of the lung. It is often associated with autoimmune disorders, such as rheumatoid arthritis and Sjogren’s syndrome, as well as infections and certain medications.

Imaging modalities, such as CT and X-ray, can be useful in the diagnosis and management of LIP.

CT:

  • CT is a highly sensitive modality for the evaluation of LIP, as it can demonstrate the characteristic thin walled cysts.
  • It can also be used to evaluate for complications, such as bronchiectasis or pneumonia.
  • CT can be particularly useful for monitoring disease progression and response to treatment.

MRI:

  • MRI is not commonly used for the evaluation of LIP, as it is less sensitive than CT for detecting interstitial infiltrates.
  • However, it can be useful in certain situations, such as in patients with contraindications to CT (e.g. allergy to iodinated contrast).
  • MRI can also provide functional information about the lung, such as ventilation and perfusion.

X-ray:

  • X-ray can be used to assess the size and shape of the heart and great vessels, as well as to evaluate for any abnormalities in the lung tissue.
  • However, X-ray is less sensitive than CT or ultrasound for the evaluation of LIP, as it may not demonstrate the characteristic cysts as they are difficult to visualize on radiographs.
  • X-ray can be useful for monitoring disease progression and response to treatment, but it is generally less reliable than CT for these purposes.

In conclusion, imaging modalities such as CT and X-ray can be useful in the diagnosis and management of LIP. CT is the most sensitive modality for detecting interstitial infiltrates and monitoring disease progression.