ATS/ERS international multidisciplinary consensus classification of the idiopathic interstitial pneumonias

In the January issue of the American Journal of Respiratory and Critical Care Medicine the “ATS/ERS international multidisciplinary consensus classification of idiopathic interstitial pneumonias” 1 was published, and this certainly deserves an editorial comment in the European Respiratory Journal (ERJ). Previously, several classifications have been proposed, of which the most influential were the landmark histological classification of chronic interstitial pneumonias by Liebow and Carrington 2 and Liebow 3, and the recent updates of acute and chronic idiopathic interstitial pneumonias (IIP) by Katzenstein and Myers 4 and by Muller and Colby 5. A correct histological classification is of utmost importance based on the fact that prognosis and survival vary largely depending on the subset of IIP 6–8. Pathology-based diagnoses are, however, only available in a minority of patients with IIP, since the majority do not undergo surgical lung biopsy. Conversely, it has been shown that high-resolution computed tomography (HRCT) scanning, in particular, but also other clinical features, may be of discriminative diagnostic value 5, 9–11. Therefore, integrated clinical, radiological and histological classifications and definitions are mandatory. In response to this, the American Thoracic Society (ATS) and the European Respiratory Society (ERS) recently published an international consensus statement focusing on idiopathic pulmonary fibrosis (IPF), with guidelines on diagnosis and …