non-smoking lung disease pathology Flashcards
what is a primary restrictive lung disease
disease of the parenchyma
what is secondary restrictive lung disease
disease of the chest wall and pleura
3 stages of pnuemonia
acute: neutrophil infiltrates into bronchi and alveoli
early resolving: fibrin, some neutrophils, macrophages and lymphocytes
organising: granulation tissue in alveolar airspaces
3 effects of smoking in the respiratory sytem
- mucosal irritant (bronchitis)
- destruction of the alveolar walls (emphysema)
- carcinogenesis
what triad of diseases make up COPD
emphysema; chronic bronchitis; chronic bronchiolitis
chronic bronchitis vs obstructive bronchiolitis
CB: hypersecretory
OB: obstructive
why is sputum purulent in chronic bronchitis
cilia paralysis leading to infections
why does emphysema present with a minimal cough
alveoli implicated rather than conducting zone
what are the 2 mucous layers
sol - cilia
gel - surface (traps particles)
what occurs in chronic obstructive bronchiolistis
small bronchi and proximal bronchioles are affected - inflammation leading to thickenin og the wall, peribronchiolar fibrosis, goblet cell hyperplasia and loss of clara cells
role of clara cells
secrete anti inflammatory factors - protease inhibitors + endothelin (vaso+broncho constrictor)
why is centrilobular emphysema the most common
this is the area most frequently hit but tobacco smoke
what type of emphysema is commonly seen in those with congenital a1 antitrypsin deficiency
panacinar
what are 3 smoking related ILDs
respiratory bronchiolitis; respiratory bronchiolitis associated interstitial lung disease; desquamative interstitial pneumonia
what metaplasia often occurs in the respiratory tract and what are the long term implications
noxious tobaccos smoke not tolerated by columnar epithelium -> changes to more resilient squamous epithelium
long term - reduciton in fucntion and incread propensity for malignant transformaiton BUT is reversible on smoking cessation
5 symptoms of lung cancer
persistant cough; pain; weight loss; haemoptysis; fatigue
4 signs of lung cancer
dull percussion; tar staining; clubbing; cachexia
4 other factors that contribute to increased lung cancer risk
industrial exposures (asbestos, arsenic etc.); radiation (treatment for other cancers esp breast); air pollution; genetics
what is the most common type of lung cancer seen in non-smokers
adenocarcinoma
common cancers that metastasize to the lung (5)
colorectal; renal; breast; melanoma; oesophagus (direct spread)
what prognostic information is provided by pathologists on lung excisions
type of tumour; size; margins; pleural involvement; vascular invasion; involvement of adjacent structures; lymph nose involvement
what is a new target in molecular analysis for cancer treatment and why
PG-L1 - expressed by malignant cells and inactivates T cells, by targeting this a T cell response against malignant cells can be launched
3 Es of cancer immuno-editing
elimination; equilibrium; escape
