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What is lip here
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LIP = Lymphoid Interstitial Pneumonia
In the context of your notes (cystic lung diseases on CT), LIP stands for Lymphoid Interstitial Pneumonia.
What is LIP?
LIP is a diffuse interstitial lymphoid infiltrate of the lung. It resembles lymphoma histologically but behaves clinically like a chronic interstitial pneumonia. Evolution to frank lymphoproliferative malignancy is rare.
Key Associations
- Autoimmune disease - most classically Sjögren syndrome
- Dysproteinaemias
- HIV infection
- Viral and mycobacterial infections
- Autologous bone marrow transplantation
- Twice as common in women
CT (HRCT) Findings
As your notes say: cysts + GGO (ground-glass opacity)
More specifically:
| Finding | Detail |
|---|---|
| Thin-walled cysts | 1-30 mm, discrete, sometimes clustered, tend not to be subpleural |
| Ground-glass opacity | Patchy distribution |
| Nodules | Varying sizes, often ill-defined |
| Septal thickening | Interlobular septal thickening |
| Bronchial changes | Thickened bronchovascular bundles |
| Distribution | Lower lobe predominant |
Here is what LIP looks like on CT - notice the bilateral thin-walled cysts and ground-glass opacity predominantly in the lower lobes:
How to distinguish from other cystic lung diseases:
-
LAM: uniform thin-walled cysts throughout both lungs, young women, no GGO predominance
-
LCH: bizarre-shaped thick-walled cysts + nodules, upper lobe, smoker
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LIP: thin-walled cysts + GGO, lower lobe, associated with immune disorder (especially Sjögren syndrome or HIV)
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Grainger & Allison's Diagnostic Radiology, Fig. 9.11; Murray & Nadel's Textbook of Respiratory Medicine
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