Interstitial Lung Disease 2 - Pathology

Question 0

4 different histological patterns of interstitial lung disease?

Answer 0

Chronic inflammation.
Type II pneumocyte hyperplasia.
Granulomas
Fibrosis.

Question 1

What does “interstitium” really refer to..?

Answer 1

Alveolated lung parenchyma

Question 2

“Organizing fibrosis” - is it reversible?

Answer 2

Yes, potentially.

Moreso than honeycomb fibrosis etc.

Question 3

3 things (listed in this lecture) that can cause UIP other than IPF?

Answer 3

Asbestosis.
Radiation exposure.
Connective tissue disease.

Question 4

Histological features of UIP?

Answer 4

Dense collagen.
Minimal chronic inflammation.
Scattered fibroblastic foci.

Question 5

What do the affected lymph nodes of a patient with sarcoidosis look like in histology?

Answer 5

Many confluent non-necrotizing granulomas.

Question 6

What does hypersensitivity pneumonitis look like in histology?

Answer 6

Small airway histology.

Diffuse chronic interstitial inflammation.

Question 7

Common allergens in hypersensitivity pneumonitis?

Answer 7

Mold.

Bird poop.

Question 8

Should you consider drug-mediated injury as a possible cause of interstitial lung disease?

Answer 8

yup.

Question 9

What behavior enhances the deleterious effects of dust exposure?

Answer 9

Smoking - the cilia won’t work as well to clear the crap.

Question 10

What is a ferruginous body?

What do they indicate?

Answer 10

An asbestos fiber that macrophages have coated with iron and glyoprotein.
These indicate asbestos exposure - not asbestosis.

Question 11

What is asbestosis? (what is it not?)

Answer 11

Asbestosis is severe peribronchiolar and then interstitial fibrosis, most severe in the lower lobes - with ferruginous/asbestos bodies.
(It’s not calcified pleural plaques, it’s not asbestos-associated cancer.)