Lung pathology related to smoking

Question 1

What are the 3 main effects of the components of tobacco?

Answer 1

carcinogenesis
addiction
inflammation

Question 2

Effects of smoking on the respiratory system and what they lead to

Answer 2

mucosal irritant –> bronchitis, respiratory bronchiolitis–associated interstitial lung disease (RBILD)

destruction of alveolar walls –> emphysema

carcinogenesis –> lung cancer

Question 3

List 3 diseases under the term smoking-related interstitial lung disease

Answer 3

respiratory bronchiolitis
respiratory bronchiolitis associated ILD
desquamative interstitial pneumonia

Question 4

Pathology of smoking-related ILD

Answer 4

mucosal irritation/inflammatory reaction of the alveoli resulting in an alveolar filling effect

alveolar spaces filled with alveolar macrophages

Question 5

Define metaplasia

Answer 5

reversible change from one differentiated cell type to another differentiated cell type

Question 6

Describe an example of metaplasia in the respiratory tract

Answer 6

noxious tobacco smoke not tolerated by columnar epithelium
squamous epithelium more resistant to thermal and chemical damage
reversible on smoking cessation

change in cell type causes reduced function and increased propensity for malignant transformation

Question 7

Lung cancer risk factors

Answer 7

smoking
industrial exposures (asbestos, arsenic, chromium, uranium, nickel, vinyl chloride, mustard gas)
radiation
air pollution
molecular genetics

Question 8

What is an adenocarcinoma?

Answer 8

gland-forming tumour

Question 9

Which cancers commonly metastasise to the lungs?

Answer 9

colorectal
renal
breast
melanoma
direct spread from oesophagus

Question 10

How is lung cancer diagnosed?

Answer 10

bronchial washings and brushings
EBUS TBNA (endobronchial ultrasound-guided transbronchial needle aspiration)
lung biopsy
bronchial biopsy

Question 11

What information about a tumour is included in a report of a lung excision?

Answer 11

type of tumour
size
margins
pleural involvement
vascular invasion
involvement of adjacent structures
lymph node involvement