Giant cell interstitial pneumonia without exposure to hard metals
Authors:
Barbora Krajsová; Tomáš Tichý
Authors‘ workplace:
Ústav klinické a molekulární patologie LF UP a FN Olomouc
Published in:
Čes.-slov. Patol., 49, 2013, No. 3, p. 141-143
Category:
Original Article
Overview
We describe the case of a 58-year-old woman with giant cell interstitial pneumonia without any history of exposure to hard metals. Giant cell interstitial pneumonia (GIP) is a rare interstitial lung disease characterized by the presence of numerous multinucleated giant cells in the alveolar spaces. Currently GIP is regarded as secondary interstitial pneumonia. While it has become almost synonymous with hard metal lung disease (cobalt pneumonitis), the literature has also included sporadic cases of GIP without exposure to hard metals. This fact undermines the synonymical relationship between GIP and hard metal lung disease. The alteration of lung tissue in GIP is immunologically mediated. In our patient we found a classical histological picture of GIP with lymphoid hyperplasia. At the time of diagnosis she was being treated for Hashimoto´s thyreoiditis. Later, autoimmune hemolytic anemia and bronchial asthma developed. We suggest that our case supports the hypothesis of the autoimmune ethiology of idiopathic GIPs.
Keywords:
giant cell intersticial pneumonia – hard metals – autoimmunity
Sources
1. Nemery B, Abraham JL. Hard metal lung disease. Still hard to understand. Am J Respir Crit Care Med 2007; 176(1): 2–3.
2. Travis WD, Colby TV, Koss MN, et al. AFIP Atlas of Nontumor Pathology. Non-neoplastic disorders of the lower respiratory tract. First Series, Fascicle 2. AFIP 2002: 840–842.
3. Leslie KO, Wick MR. Practical pulmonary pathology. A diagnostic approach, 2nd edition, Elsevier Saunders; 2011: 329–332.
4. Naqvi AH, Hunt A, Burnett BR, Abraham JL. Pathologic spectrum and lung dust burden in giant cell intersticial pneumonia (hard metal disease/cobalt pneumonitis): Review of 100 cases. Arch Environ Occup Health 2008; 63(2): 53–70.
5. Keiko O, Kazuioki K, Yoshikazu K, et al. A case of hard metal lung disease resembling a hypersensitive pneumonia in radiological images. Inter Med 2010; 49(12): 1185–1189.
6. Katzenstein AL, Myers JL. Idiopathic pulmonary fibrosis: clinical relevance of pathological classification. Am J Respir Crit Care Med 1998; 157(4): 1301–1315.
7. Reudiger HW. Hard metal particles and lung disease: Coincidence or causality? Respiration 2000; 67(2): 137.
8. Moriyama H, Kobayashi M, Takada T, et al. Two-dimensional analysis of elements and mononuclear cells in hard metal lung disease. Am J Respir Crit Care Med 2007; 176(1): 70–77.
9. Frost AE, Keller CA, Brown RW, et al. Giant cell intersticial pneumonitis. Disease recurrence in the transplanted lung. Am Rev Respir Dis 1993; 148(5): 1401–1404.
10. Menon B, Sharma A, Kripalani J, Jain S. Giant cell interstitial pneumonia in a 60-year-old female without hard metal exposure. Respiration 2006; 73(6): 833–835.
Labels
Anatomical pathology Forensic medical examiner ToxicologyArticle was published in
Czecho-Slovak Pathology
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2013 Issue 3
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