According to ATS/ERS 2022 guidelines, which HRCT pattern in Idiopathic Pulmonary Fibrosis (IPF) is classified as 'Typical UIP' and can confirm diagnosis WITHOUT surgical lung biopsy?

• A Bilateral ground-glass opacities predominant in upper lobes with peribronchial distribution
• B Crazy-paving pattern with bilateral consolidation and GGO
• C Peribronchovascular distribution of fibrosis with upper lobe predominance
• D Honeycombing with or without peripheral traction bronchiectasis, basal and subpleural predominance ✓

Explanation

The ATS/ERS/JRS/ALAT 2022 IPF guidelines define the Typical UIP pattern on HRCT as: honeycombing (basal and subpleural/peribronchovascular predominance), with or without peripheral traction bronchiectasis, without features suggesting alternative diagnosis. This pattern has high specificity (~90%) for UIP/IPF and can confirm the diagnosis without lung biopsy in the appropriate clinical context. Probable UIP shows traction bronchiectasis without honeycombing. Upper lobe or peribronchovascular patterns suggest alternative diagnoses such as HP or sarcoidosis.

Reference: Harrison's Principles of Internal Medicine, 21st ed.

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Written and medically reviewed by the StethoPrep medical team.