Diagnostic approach to interstitial lung disease

摘要

Interstitial lung disease includes a variety of entities with strikingly diverse natural histories and treated outcomes. Thus, in clinical practice, an accurate diagnosis is essential in order to construct an optimal treatment strategy. The gold standard for diagnosis is now a multi-disciplinary diagnosis, with participation by clinicians, radiologists, and, when applicable, histopatholologists. In non-biopsied cases, the clinical and High Resolution Computed Tomography (HRCT) evaluations are, on average, equally influential. Key clinical information includes the identification of a cause or relevant underlying systemic disease, and the assimilation of serial data allowing definition of the natural history or treated course of disease. In patients undergoing surgical biopsy, clinical and HRCT findings are usually inconclusive and the histological features tend to carry the most diagnostic weight. However, it should be expected that the final diagnosis will differ from the histological diagnosis in a significant minority of patients, when all available information is integrated.