The term 'lymphoid interstitial pneumonia' (LIP) was proposed by Liebow and Carrington to describe a disease entity characterised by a widespread interstitial lymphoid infiltrate of the lung, resembling lymphoma but with a clinical course more akin to a chronic interstitial pneumonia. Although in the past LIP has been considered by some to be a pulmonary lymphoproliferative disorder, evolution to frank lymphoproliferative disease is rare and thus LIP remains within the group of interstitial pneumonias. Classically, LIP occurs in association with autoimmune diseases, most often Sjögren's syndrome. Other diseases associated with LIP include dysproteinaemias, autologous bone marrow transplantation and viral, mycobacterial and human immunodeficiency virus (HIV) infections. LIP is approximately twice as frequent in women and symptoms of progressive cough and dyspnoea usually predominate. Common HRCT findings are nodules of varying sizes (which may be illdefined), areas of ground-glass opacification, thickened bronchovascular bundles, interlobular septal thickening and thin-walled cysts (1–30 mm) (Fig. 1). Airspace disease, large nodules and pleural effusions are rare in these patients. The cysts in LIP are usually discrete, sometimes clustered and tend not to be subpleural.
Classic HRCT Findings
• Patchy ground-glass opacities, indistinct nodules and thin-walled cysts
FIGURE 1 ■ Lymphoid interstitial pneumonitis. There are patchy ground-glass opacities and a few thin-walled cystic air spaces in the right lung.
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