Linking histology to clinical diagnosis in interstitial lung disease

Venerino Poletti​
University of Bologna,Bologna, Italy

Interstitial lung disease (ILD) encompasses a heterogeneous group of disorders with varying aetiologies, prognoses, and treatment approaches. Histopathology remains a crucial component in the diagnostic process, particularly when imaging and clinical features are inconclusive. This lecture explores the role of histological patterns such as usual interstitial pneumonia (UIP), nonspecific interstitial pneumonia (NSIP), organizing pneumonia (OP), and diffuse alveolar damage (DAD) and their correlation with clinical syndromes including idiopathic pulmonary fibrosis (IPF), connective tissue disease-associated ILD, hypersensitivity pneumonitis, and drug-induced lung injury.

Accurate interpretation of lung biopsy findings, whether obtained via transbronchial cryobiopsy or surgical lung biopsy, requires integration with clinical history, radiologic patterns on high-resolution CT (HRCT), and serological data. This multidisciplinary approach enhances diagnostic confidence and helps differentiate between idiopathic and secondary causes of ILD, which has direct implications for prognosis and treatment selection.

Linking histology to clinical diagnosis is essential in achieving an accurate and timely diagnosis in ILD, ultimately enabling more effective and personalized patient care. The multidisciplinary team including pulmonologists, radiologists, and pathologists plays a central role in synthesizing this complex information to inform optimal management strategies.