Correct!
3. Review his lung biopsy

His diagnosis is clinically unclear, and therefore, starting therapy is not indicated. Representative images from his lung biopsy are shown in Figure 3.

Figure 3. Representative images from lung biopsy. A: Low power, H & E staining showing accumulation of cells and fibrosis. B: higher power view showing fibrosis. C: higher power showing accumulation of cells. D: high power view showing accumulation of cells containing intracellular granules with a brownish pigment (smoker’s macrophages).

The biopsy was interpreted as showing “predominately smoking-related changes in the form of desquamative interstitial pneumonia. There is a significant amount of fibrosis associated with it. Superimposed, are areas of organizing pneumonia”. 

Which of the following are true regarding desquamative interstitial pneumonia (DIP)? (Click on the correct answer to proceed to the fifth and final page)

  1. Smoking cessation often leads to improvement
  2. May progress to form a non-specific interstitial pneumonitis (NSIP) pattern
  3. Usually responds to corticosteroids
  4. 1 and 3
  5. All of the above

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