Interdisciplinary diagnostics for interstitial lung diseases: what is recommended?

Background: The diagnosis of the heterogeneous group of interstitial lunge diseases (ILD) demands sophisticated skills and requires a close cooperation of the various medical disciplines. Objective: How are the diagnostics of suspected ILD carried out in a state of the art approach ? Material and method: The joint efforts of a multidisciplinary expert panel (pneumology, thoracic surgery, radiology, pathology, rheumatology) established a consensus document that covered the most important diagnostic aspects with respect to ILD. Results: An adequate diagnostic approach in ILD requires the following: i) detailed medical history taking, ii) focused physical examination, iii) thin layer high-resolution multidetector computed tomography (CT) scan of the chest, iv) rheumatological and immunological serology, v) bronchoscopy including bronchoalveolar lavage (BAL), histology and sample preparation, if indicated and with appropriately high levels of expert analysis. Every suspected ILD case requires a multidisciplinary discussion (ILD board) among the abovementioned experts at two points in time: i) before bronchoscopy and histological sampling is performed and ii) after all results (including histology, if applicable) are available. Conclusion: It is highly recommended to carry out a standardized diagnostic approach in all suspected ILD cases including a multidisciplinary discussion (ILD board).