ILD Oct11 M2 Flashcards
Idiopathic interstitial pneumonias, some diseases
- Usual interstitial P
- Nonspecific interstitial P
- Acute interstitial P
- Cryptogenic organizing P
- Desquamative interstitial P
- Lymphocytic interstitial P
- Respiratory bronchiolotis interstitial lung disease (RBILD)
Why idiopathic interstitial pneumonias is a bad name (2)
- We know RBILD for ex is caused by cigarette smoking
- COP is in alveolar airspace and lumen or resp bronchioles
Clinical counterpart of usual interstitial pneumonia (UIP)
idiopathic pulmonary fibrosis (IPF)
pathological counterpart of nonspecific interstitial pneumonia (NSIP)
NSIP
pathological counterpart of acute interstitial pneumonia (AIP)
diffuse alveolar damage
pathological counterpart of cryptogenic organizing pneumonia (COP)
organizing pneumonia
idiopathic pulmonary fibrosis (IPF) examples of symptoms
dyspnea, non productive cough, clubbing of fingers and toes
IPF CT findings
thickened linear lines, prominent along pleura. Holes in the lines
UIP macroscopic findings
honeycombing (wasp nest like spaces)
UIP location
peripheral, subpleural
what interstitium affected by UIP
parenchymal interstitium
Most important pathologic feature of fibrosis
something activates fibroblasts to produce collagen
UIP distribution and inflammation extent
patchy distribution (intra and interlobular severity) Mild interstitial inflammation
UIP progression of fibrosis and structural changes
biphasic fibrosis (on and off) Architectural remodelling (honeycombing)
how pleura and interlobular septa are affected in UIP
stay normal bc doesn’t affect non parenchymal IS
UIP what happens to alveolar wall and airspaces as it becomes more severe
alveolar septum IS thickened by lymphocytes and collagen.
airspaces contain macrophages
two phases of idiopathic pulmonary fibrosis (IPF) and which was easier to treat
Alveolitis (interstitial pneumonitis)
Fibrosis
Alveolitis easier to treat
IPF prognosis
mean survival from onset is 5 years. few respond to steroids
ILDs: how affect
compliance
decreased
ILDs: how affect
elasticity and elastic recoil (elastance)
increased
ILDs: how affect TLC, RV, VC
TLC decreased
RV same or little decreased
VC decreased
ILDs: how affect diffusion capacity
decreased
ILDs: how affect large airway caliber
unchanged or increased a little (scarring pulls them open in advanced disease)
name for slight increase of large airway caliber in advanced ILD
bronchiectasis
ILDs: how affect small airway caliber
decreased
respiratory pattern of ILD (UIP included)
rapid and shallow breathing
auscultation findings in ILDs (UIP included)
crepitations
advanced ILD particular finding
cyanosis
acute interstitial pneumonia (AIP) examples of symptoms
fever, fatigue, muscle aches, headaches, dyspnea,
medical word for muscles aches
myalgia
AIP (diffuse alveolar damage) macroscopic appearance
diffuse small holes in the lung
Reason for small holes in the lung in AIP
branching bronchioles are empty and alveolar airspaces are filled with material and are consolidated. Same principle as air bronchogram
High magnif: what we see in AIP (2) + name of phenomenon
alveolar septum contains neutrophils (shows IS pneumonitis)
pink eosinophilic material (fluid and protein and dead cells)
UIP vs diffuse alveolar damage of AIP
UIP: lymphocytes and slow fibrosis
AIP: toxic injury to endothelium and alveoli. leak of protein in airspace
name of what we see on airway lining in AIP + name for the IS inflam _ protein leak in alveolar airspace
Hyaline membrane
Diffuse alveolar damage
Cryptogenic organizing pneumonia (COP) examples of symptoms
productive cough, yellow sputum, low grade fever
COP CXR findings + name for that
fluffy disease, airspace pattern. : Patchy airspace disease
COP CT findings
fluffy disease, airspace pattern + AIR BRONCHOGRAM
Organizing pneumonia: distribution and inflammation how and where
Patchy and varies within and between lobes
Mild IS inflammation
Organizing pneumonia: where fibrosis happens (where fibroblasts are)
fibroblastic tissue in resp bronchioles, alveolar duct lumens and airspaces
Why COP classified in IS pneumonitises if shows consolidation on CT
Bc often see interstitial pneumonitis with the disease (mild-moderate IS inflammation)
Fibroblastic tissue similarity and difference in UIP vs COP
same fibroblastic tissue in both but is in alveolar airspace in COP
how alveolar septa appear in COP on microscopy
thickened with lymphocytes: IS pneumonitis
diffuse alveolar damage: what + seen in what disease
hyaline membrane lines airways, IS inflammation, alveolar airspace filled with protein and fluid
