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Vol. 10. Issue 4.
Pages 331-345 (July - August 2004)
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Vol. 10. Issue 4.
Pages 331-345 (July - August 2004)
CASO CLÍNICO/CLINICAL CASE
Open Access
Pneumonite intersticial não específica: entidade clínico-patológica, padrão histológico ou apenas grupo heterogéneo de pneumonites intersticiais não classificadas?
Nonspecific interstitial pneumonitis: a clinicopathologic entity, histologic pattern or unclassified group of heterogeneous interstitial pneumonitis?
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António Morais*, M. Conceição Souto Moura**, M. Rosa Cruz***, Isabel Gomes*
* Serviço de Pneumologia, Hospital de S. João.Alameda Prof. Hernâni Monteiro 4202-451 - Porto.
** Serviço de Anatomia Patológica, Hospital de S. João.Alameda Prof. Hernâni Monteiro 4202-451 - Porto.
*** Serviço de Cirurgia Torácica do Hospital São João, Serviço de Pneumologia. Alameda Prof. Hernâni Monteiro 4202-451 - Porto.
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RESUMO

A pneumonite intersticial não específica (NSIP), descrita pela primeira vez em 1994 por Katzenstein e Fiorelli, apresenta-se como uma eventual entidade clínico-patológica individualizável dentro do grupo das pneumonites intersticiais idiopáticas (IIP). Aliada a alterações histológicas distintas, apresenta

uma evolução clínica mais favorável, com consequente melhor prognóstico do que a fibrose pulmonar idiopática (IPF), grupo onde geralmente estas alterações eram incluídas. Estas diferenças levam a que, apesar das dúvidas que ainda envolvem a NSIP, o seu reconhecimento seja importante, uma vez que as atitudes clínicas e terapêuticas se diferenciam da IPF. A NSIP engloba padrões histológicos diferentes, dividindo-se nomeadamente em casos de predomínio inflamatório (tipo celular) ou de predomínio fibroso (tipo fibrosante), com os últimos a evidenciarem uma maior gravidade e pior prognóstico do que os primeiros. Os autores descrevem dois casos de NSIP, seguidos de uma revisão e discussão do tema.

REV PORT PNEUMOL 2004; X (4): 331-345

Palavras chave:
pneumonites intersticiais idiopáticas
pneumonite intersticial não específica: tipo celular
tipo fibrosante
ABSTRACT

Nonspecific interstitial pneumonitis (NSIP) initially described by Katzenstein and Fiorelli in 1994, seems to be a distinct clinicopathologic entity among idiopathic interstitial pneumonitis (IIP). Besides different histologic features from other IIP, NSIP is characterized by a better long-term outcome, asso

ciated with a better steroids responsiveness than idiopathic pulmonar fibrosis (IPF), where usually were included. Thus, differentiating NSIP from other IIP, namely IPF is very significant, since it has important therapeutic and prognostic implications. NSIP encloses different pathologies, namely those with inflammatory predominance (cellular subtype) or fibrous predominance (fibrosing subtype). NSIP is reviewed and discussed by the authors, after two clinical cases description.

REV PORT PNEUMOL 2004; X (4): 331-345

Key words:
idiopathic interstitial pneumonitis
non-specific interstitial pneumonitis
cellular subtype
fibrosing subtype
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Copyright © 2004. Sociedade Portuguesa de Pneumologia/SPP
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