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They were asked to classify the histopathologic pattern according to the 2002 ATS/ERS statement on IIP (1) as follows: UIP, nonspecific interstitial pneumonia, organizing pneumonia, diffuse alveolar damage, respiratory bronchiolitis, desquamative interstitial pneumonia, and other specific diseases.
Given that most patients with PLCH are smokers, it is not surprising that the background lung parenchyma might show smoking-related changes including respiratory bronchiolitis, desquamative interstitial pneumonia, and/or emphysema (Figures 2, B, and 4, E).
These alterations have been described over decades as separate diseases, including emphysema, (4) respiratory bronchiolitis, (3) respiratory bronchiolitis-interstitial lung disease, (5) desquamative interstitial pneumonia, (6) and pulmonary Langerhans' cell histiocytosis.