CTICasesLymphoid Interstitial Pneumonia (LIP) progressing to Fibrosis
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Imaging findings
An older CT scan from 2007 shows patchy peripheral ground-glass opacity, somewhat denser in a few areas, with one discernible cyst. This pattern was initially considered organizing pneumonia. An open surgical biopsy confirmed a textbook diagnosis of Lymphoid Interstitial Pneumonia (LIP), describing interstitial expansion and polyclonal cells, ruling out lymphoma. A follow-up scan nine years later (2016) demonstrates the evolution to diffuse fibrosis, with honeycombing in the right apex, peripheral reticulation, and the persistence of the previously noted cyst. Some areas show clearing, while others have worsened.
Key takeaways
Lymphoid Interstitial Pneumonia (LIP), often associated with underlying collagen vascular disease, can present with a range of patterns, including peripheral ground-glass opacity, cysts, and even organizing pneumonia-like features. Crucially, LIP has the potential to progress to advanced fibrosis and honeycombing over time, representing a recognized fibrotic evolution of this interstitial pneumonia.
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