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Image 23
NSIP, low magnification
Nonspecific interstitial pneumonia with fibrosis: This scanning magnification view is characteristic of the biopsy findings. Note the dilated terminal bronchiole (TB) within 1 cm of the pleura. This occurrence is a function of traction bronchiolectasis where surrounding parenchymal scar has contracted, pulling the distal airways open. Tractional forces related to scarring can result in small cystic spaces at the lung periphery. Serial CT images may reveal connection of these spaces to more central airways. Note the diffuse thickening of alveolar septa (S) with some confluence (C) by fusion of adjacent alveolar walls. All of the lung parenchyma in the biopsy is abnormal in this way, in contrast to UIP where variable fibrosis is characteristic, along with interspersed normal lung. (Hematoxylin and eosin stain, 12.5X original magnification.)
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