20th February 2025

Desquamative interstitial pneumonia (DIP)

Often considered the end stage of RB-ILD, in DIP pigmented alveolar macrophages accumulate in alveolar spaces.

Dyspnoea and cough develop over weeks to months and clubbing may be seen on examination.

Investigations include:

• HRCT: ground-glass opacities, predominantly in the bases or peripheries
• Biopsy: usually required for diagnosis; diffuse accumulation of pigmented macrophages in alveolar spaces

As with RB-ILD, the mainstay of treatment is smoking cessation, but steroids may also be used.