Giant Cell Interstitial Pneumonia (GIP)

Abstract

Three cases of an unusual interstitial pneumonia, designated by Liebow as giant cell interstitial pneumonia, were encountered by us. Dyspnea, weight loss, cough, chest pain, rales in the lungs and clubbing of the fingers were the frequently observed clinical features. Roentgenographically, there were bilateral, patchy, nodular infiltrates of varying density, more prominent in the midlung fields. Histologic features are quite striking, characterized by predominant lymphocytic interstitial infiltrate along with numerous, bizarre, multinucleated giant cells in the alveoli as well as varying numbers of alveolar pneumocytes. The intra-alveolar cells showed a positive reaction with PAS and iron stains. Extensive etiologic studies undertaken in one case were negative. The clinical, radiologic and functional improvement seen in our first case indicates that corticosteroids may induce a rewarding remission. The alteration of histologic features after steroid therapy, suggests a possible relationship between giant cell interstitial pneumonia and desquamative interstitial pneumonia. Three cases of an unusual interstitial pneumonia, designated by Liebow as giant cell interstitial pneumonia, were encountered by us. Dyspnea, weight loss, cough, chest pain, rales in the lungs and clubbing of the fingers were the frequently observed clinical features. Roentgenographically, there were bilateral, patchy, nodular infiltrates of varying density, more prominent in the midlung fields. Histologic features are quite striking, characterized by predominant lymphocytic interstitial infiltrate along with numerous, bizarre, multinucleated giant cells in the alveoli as well as varying numbers of alveolar pneumocytes. The intra-alveolar cells showed a positive reaction with PAS and iron stains. Extensive etiologic studies undertaken in one case were negative. The clinical, radiologic and functional improvement seen in our first case indicates that corticosteroids may induce a rewarding remission. The alteration of histologic features after steroid therapy, suggests a possible relationship between giant cell interstitial pneumonia and desquamative interstitial pneumonia.