Interstitial lung disease (ILD)

Question 1

What are interstitial lung diseases (ILD)?

Answer 1

ILD is a general term to describe a number of conditions that primarily affect the lung parenchyma in a diffuse manner.

They are characterised by chronic inflam and or progressive interstitial fibrosis.

They share a number of clinical & pathological features.

Question 2

What are the pathological finding of ILD?

Answer 2

• Fibrosis & remodelling of interstitium
• Chronic inflammation
• Hyperplasia of type 2 epithelial cells/ pneumocytes

Question 3

What are the clinical features of ILD?

Outline the investigations for ILD’s

Answer 3

Symptoms

• Dyspnoea
• Cough
• Resp failure

Investigations

• Pulmonary function tests - diagnostic
  
  • Restrictive [FIBROSIS loss of elastic recoil]
    
    • ↓TLV, ↓RV, ↓DLco (diffusing capacity for lung CO)
• CXR - abnormal
• **High res CT **- honeycombing = advanced
• Biopsy

Question 4

How would you classify ILD?

State some causes.

Answer 4

SHIT FACED.

• Sarcoidosis
• Histiocytosis
• Idiopathic pulmonary fibrosis
• TB or Tumor
• Fungal infections
• Asbestos or Alveolar proteinsosis
• Collagen vascular disease (RA, SLE etc)
• Environment/ occupation
  
  • Coal - worker’s pneumoconiosis
  • Farmer -‘s lung, extrinsic allergic alveolitis
  • Potter - silica dust, silicosis
  • Asbestos - mesothelioma
• Drugs