HISTOLOGICAL SPECTRUM OF NON-NEOPLASTIC LESIONS IN THE LUNG-A RETROSPECTIVE STUDY DONE ON LOBECTOMY SPECIMENS

ABSTRACT

To study the histolopathological spectrum of non-neoplastic lesions of lung and to evaluate in relation to age, gender and clinico-radiological findings. This study is done over a period of 1 year (Nov 2020 to Nov 2021) in the Department of Pathology, LNMC, Bhopal. Total of 33 lobectomy specimens were studied. Specimens were fixed in formalin and paraffin embedded H&E-stained tissue sections were studied. Special stains (Gomorri's methenamine silver stain and Periodic acid Schiff stain) were done where ever required. Non-neoplastic lesions from 3 (9.09%) women and 30 (90.90%) men, with a median age of 43.86 (Interquartile range 23-60 years) were collected. Fibrotic interstitial changes comprised the most common category of histologic findings, noted in 20 (60.6%) patients. Most cases consisted of usual interstitial pneumonia (UIP) (30.30%), followed by smoking related interstitial fibrosis/SRIF (desquamative interstitial pneumonia like patterns and respiratory bronchiolitis like pattern) (12.12%), non-specific interstitial pneumonia (NSIP) (9.09%) and patterns of “undefined” fibrosis (6.06%) such as peribronchial fibrosis, organizing pneumonias and other patterns of fibrosis that did not fall into a recognized category of idiopathic interstitial pneumonia. Granulomatous pathology was identified in 4 (10.81%) patients. On chest X-ray/CT scan chest, majority of lung lesions presented as diffuse and patchy opacities with honeycombing and bronchiectasis. Cigarette smoking was associated with 4 lung lesions. Histopathologic classification plays an important role in separating variable forms of non-neoplastic lung lesions & further subcategorising idiopathic interstitial pneumonia into clinically meaningful categories have important differences in natural history, prognosis, and treatment