Interstitial Lung Disease Flashcards
What is interstitium
Connective tissue between alveoli (aka alvoelar septa) and around vessels and airways (where lymphatics are)
Airspace vs. interstial dz
Arspace - normal alveolar septae and inflamms are in alveolar sapces
Interstitial - thickened alveolar septae and air-filled alveolar spaces
Progression
May begin as alveolitis (airspace involvement)
Is unchecked, recrutied fibrobalsts can lay down collagen to produce intersittial thickeneing (and therefore decreased compliance and diffusion cpacity)
If it continues, then end stage
IPF
Hx, exam, radiography, pathology, neraly identical
Idiopathic pulmonary fibrosis
Insidious onset of dyspnea and dry cough
Small lung volumes, dry crackles, and finger clubbing
Reticular opacities that are peripheral abd basilar with honeycombing and WITHOUT ground glass
End-stage fibrosis with NOT active alveolitis
Asbesotisis***, RA, and scelroderma lung
Silicosis
Hx
Exam
Path
Nearly identical
INsidious onset of dyspnea and cough (look for exposure)
Clear lungs and no finger clubbing…depends
HYalizined collagenous nodules with polarizable silica particles
Coal works pneuimocoioniss***, and sacrodisosi *radio)
Simple vs. complicatied silicosis radio
Simple - micronodular opacities with sharpt margins in mid and upper lung…often with LAD
Progressive massive fibrosis (complicated) - conglomerate lesions with retractiion
Cryptogenic organizing pneumonia
Hx Exam Radio Path Others
Variable including fever and dyspnea…often after resp or insidious
Rales…nroaml sized lungs and NO clubbing
Airspace filling dz that may look like bacterial pneumonia
Myxomatous tissue in small airways that spreads to alvolear
Esosinophilic pneumonia, alveolar proteinosis and alveolar hemorrhage
Hypersensitivity pneumonitis
Varies with intensity and chronicitivyt, but the inciting antigen must be inhaled***
Radiation related lung dz
Early pneumonitis (like cryptogenic organizing penumonia) and later with fibrosis that conforms to radition port
