Chronic diffuse interstitial (restrictive) diseases Flashcards
What are the characteristics of chronic diffuse interstitial (restrictive) lung diseases?
Interstitial inflammation and fibrosis
Pulmonary function studies indicative restrictive lung disease (decreased diffusion capacity, lung volume and lung compliance
What are the clinical findings of restrictive diseases? 4
Dyspnoea, tachypnoea, end-inspiratory crackles, eventual cyanosis
What are the 2 complications of restrictive lung disease?
secondary pulmonary hypertension and cor pulmonale (right-sided heart failure)
What determines development Pneumoconiosis?
Development of disease depends on the amount of dust retention, the size, solubility and cytotoxicity of
the dust particle, particle uptake by / transit across epithelial cells and activation of the inflammasome
What is coal worker’s pneumoconiosis?
Lung disease caused by inhalation of coal particles and other admixed forms of dust
* Seen in coal miners,city dwellers and smokers;
Types of coal workers pneumoconiosis
Simple CWP
Complicated CWP
What are the 3 characteristics of Simple CWP?
(i) Coal macules (carbon-laden macrophages) (ii) Coal nodules (upper lobes more heavily involved) (iii)
Centrilobular emphysema
Features of Complicated CWP
Develops after many years
(i) Intense blackened scars larger than 2 cm in diameter ,progressive massive
fibrosis affects lung function). (ii) Center of lesion is often necrotic
What is anthracosis?
accumulation of carbon- laden macrophages in lung
What type of pigmentation do smokers have?
mokers have more anthracotic pigmentation because of tobacco smoke tar but still do not have significant disease from the
carbonaceous pigment
Anthracosis increases risk of which disease?
TB
Lung cancer
What is asbestosis?
Asbestosis = diffuse interstitial fibrosis with asbestos bodies (golden brown, fusiform or beaded rods with a
translucent center) due to inhalation of asbestos particles in workers engaged in mining, pipes, brakes,
insulation and boilers.
Which part of the lung is first affected by asbestos?
Lower lobes of the lung pleurally
Explain the pathogenesis of asbestosis
Asbestos fibres are phagocytosed by macrophages and activate the inflammasome, stimulating the release
of proinflammatory factors and fibrogenic mediators
* In contrast to other dusts, can also act as a tumor initiator and tumor promoter
What are the 2 types of asbestos fibers?
Serpentine (curly and flexible fibres, chrysotile): These account for most of the asbestos used in industry.
* Amphibole (straight, stiff and brittle fibres, crocidolite, amosite, actinolyte): These are more pathogenic
than chrysotiles, particularly with respect to induction of mesotheliomas
T/F Pleural plaques do not contain asbestos bodies
T
What are pleural plaques
Most common
Composed of well circumscribed plaques of dense collagen containing calcium
Asymptomatic
Where do pleural plaques normally form?
Anterior and posterolateral parts of parietal pleura and over the diaphragm
Difference between asbestos body and ferruginous body
Asbestos body: iron-containing proteinaceous substance covering asbestos particle. Clear in color Ferruginous body: Iron-protein complex covering any other inorganing body other than asbestos
Which cancer is commonly cased by asbestos?
bronchogenic cancer
Increased risk with concomitant smoking
Which cancer has a specific link to asbestos inhalation? How does it occur?
Mesothelioma. Occurs when asbestos fibres are in close proximity to mesothelial surfaces such as peritoneum and pleura
Is mesothelioma associated with concomitant smoking?
No
