ILD Pathology

Question 1

define sarcoidosis

Answer 1

multi system non caseating granulomatous disease

Question 2

epi for sarcoid

Answer 2

more black than white, female than male

Question 3

main sx of sarcoid

Answer 3

SOB

Question 4

radiology of sarcoid

Answer 4

interstitial infiltrates in bronchovascular distribution, hilar adenopathy

Question 5

patho of sarcoid

Answer 5

tight, non caseating granulomas w/ giant cells, histiocytes

focal accumulation of epithelioid histiocytes

Question 6

clinical correlates of hypersensitiviy pneumonitiis

Answer 6

from organic dusts, occupational or environmental exposure

acute and chronic- dyspnea, cough, fatigue

Question 7

radiology of HP

Answer 7

bilateral interstitial or nodular pattern

Question 8

patho of HP

Answer 8

patchy interstitial expansion, peri bronchiolar and interstitial chronic inflammation (lymphs) and loose granuloma

Question 9

exposures that lead to microorganisms causing HP

Answer 9

hay, sugarcane, maple bark, hot tubs, ac units

Question 10

animal proteins causing HP

Answer 10

birds, pets, grain weevils

Question 11

synthetic causes of HP

Answer 11

organic chemicals in plastic/rubber manufacturing

Question 12

pneumoconiosis clinical

Answer 12

inorganic dust from exposure

Question 13

contrast the patho of two types of PCs

Answer 13

fibrogenic (silica, asbestos) cause active fibrin deposition

inert (coal) simply deposit in interstitium

Question 14

radiology of silicosis

Answer 14

bilateral silicotic nodules in upper compartments

Question 15

patho in early vs late silicosis

Answer 15

early: active histiocytes and fibroblasts
late: large, hyalinized, acellular fibrotic nodules

Question 16

patho of asbestosis- 2 finidings

Answer 16

patchy sub pleural fibrosis (hyaline pink),

ferruginous bodies- asbestos fiber coated w/ rust and eaten by macrophages

Question 17

patho of coal workers pneumonconiosis

Answer 17

main finding is coal dust macules (black masses in interstitium)

some destruction of parenchyma, mainly a space occupying lesion

Question 18

clinical correlate to UIP patho pattern

Answer 18

Dx is IPF- poor response to steroids and high mortality

Question 19

radiology of IPF

Answer 19

patchy subpleural infiltrates

Question 20

what else can cause same radiology pattern as IPF

Answer 20

asbestos, rheumatic disease

Question 21

patho of UIP/IPF

Answer 21

has BOTH temporal (old and new fibrosis) and spatial (pathologic and healthy) heterogeneity

patchy fibroblastic and fibrotic foci, alternating w/ normal parenchyma

Question 22

unique gross and histological change in UIP

Answer 22

honeycomb change- large holes around fibrosis in the sub pleural region