2. A heterogenous group diffuse inflammatory
disorders that affect the alveoli and septal
interstitium of the lower respiratory tract of
the lung.

3. Causes of interstitial lung diseases :
Idiopathic pulmonary fibrosis
• It is called cryptogenic fibrosing alveolitis or
Hamman – rich syndrome
• The cause is unknown but the disease
represents the inflammatory and immune
response of the lung to the tissue damage
Collagenic vascular diseases
• Rheumatoid arthritis, systemic sclerosis or
ankylosing spondylitis
• Dermatomyositis, polymyositis or mixed
connective tissue diseases

4. Occupational lung diseases
• Inhalation of organic dusts “extrinsic allergic
alveolitis” : as Baggosis
• Inhalation of inorganic dusts “
Pneumoconiosis” : as Asbestosis
Malignancy
• Bronchoalveolar carcinoma and lymphangitis
carcinomatosis
• Leukaemias and lymphomas
Infectious diseases
• Miliary tuberculosis, viral and atypical pneumonias

5. Medications
• Methotrexate, Azathioprine and bleomycin
• Sulphonamides, Aminodarone and insecticides
Miscellaneous
• Ulcerative colitis, chronic active hepatitis
• Alveolar proteinosis and microlithiasis
• Hashimoto’s thyroiditis and Goodpasture’s
syndrome

6. Pathological types
• Mural types
• Desquamative type
• Lymphocytic type

7. Symptoms :
Onset
* It usually insidious and gradually progressive
* It may be acute with rapidly progressive course
“in
Hamman rich syndrome”
* It may be subacute “in extrinsic allergic
alveolitis”
Symptoms
* Dry cough
* Gradual progressive dyspnea appearearly on

8. Sign :
General signs
• Clubbing
• Cyanosis that appears early on exertion but
later at rest
Local sign
• Crackles
• Rhonchi

9. Radiological investigations :
Chest x-ray
• Diffuse bilateral reticulonodular pattern through
both lung fields
• It is more pronounced at the lower lung zone
• Honey comb appearance
• Homogenous opacity
• Multiple shadows of equal size scattered all over
lung in milliary TB
• Features of complications : Right ventricular
enlargement , Pulmonary hypertension

10. reticulonodular infiltrates

11. distortion of the lung architecture and traction bronchiectasis

12.  HRCT ( High Resolution CT scan )
 Ventilation – Perfusion scan
Blood test : leucocyte
Other tests : bronchoscopy, lung biopsy, etc.

13. Specific Treatment :
Steroid “Prednisone”
Other lines of treatment :
Symptomatic treatment as : oxygen inhalation and
antitussive
• Supportive treatment as : good nutrition and
vitamins
• Treatment of the cause : as pulmonary
infections
• Treatment of complications as

14. Symptomatic treatment as : oxygen inhalation and
antitussive
• Supportive treatment as : good nutrition and
vitamins
• Treatment of the cause : as pulmonary
infections
• Treatment of complications as
- Pulmonary hypertension and corpulmonale