Pathology of ILD Flashcards
describe the makeup of the pulmonary interstitium
alveolar lining cells( types 1+2)
thin elastin-rich connective component containing capillary BV
what is the early stage of ILD?
alveolitis- injury with inflammatory cell infiltration
what is the late stage of ILD?
fibrosis
what are the causes of ILD?
Environmental (minerals, drugs, radiation. Post-ARDS)
Hypersensitivity (mouldy hay, avian proteins)
Unknown (idiopathic)
Connective tissue diseases
Idiopathic pulmonary fibrosis (IPF)
How is ILD often diagnosed?
biopsy
d: transbronchial biopsy
special forceps used at bronchoscopy
d: thoracoscopic biopsy
more invasive but more reliable and generates far more tissue
name some chronic interstitial diseases
Idiopathic pulmonary fibrosis (IPF) Sarcoidosis Hypersensitivity pneumonitis (extrinsic allergic alveolitis) Pneumoconiosis Connective tissue diseases
what is finger clubbing a possible symptom of?
Idiopathic pulmonary fibrosis
describe the pathology of IPF
Subpleural and basal fibrosis
Inflammatory component variable
Terminally lung structure replaced by dilated spaces surrounded by fibrous walls
what disease shows honeycombing in the slide and when?
late IPF
What is HP?
Hypersensitivity pneumonitis
Chronic inflammatory disease
what is the pathology of HP?
Small airways
Interstitium
Occasional granulomas
What is the allergic origin of HP?
Type III hypersensitivity
Type IV hypersensitivity
name 3 possible causes of HP
Thermophilic bacteria – Farmers lung
Avian proteins – Bird fanciers lung
Fungi – Malt workers lung
what is often detectable in serum of HP?
preciptins (antibodies)
d: sarcoidosis
inflammatory disease that affects multiple organs in the body
what are some other manifestations of sarcoidosis
Uveitis (inflammation of iris)
Erythema nodosum
Lymphadenopathy
Hypercalcaemia
name some ways there is pulmonary involvement in connective tissue diseases?
Interstitial fibrosis (milder than IPF)
Pleural effusions
Rheumatoid nodules
d: pneumoconiosis
Lung disease caused by mineral dust exposure
Asbestosis
Coal workers lung
Silicosis
what is asbestos?
a silicate
which asbestos fibres are relatively safe?
Serpentine (curved) asbestos fibres relatively safe
which asbestos fibres are dangerous?
Straight (amphibole) asbestos highly dangerous
name some pathological changes asbestos causes within the body?
Parietal pleural plaques
Interstitial fibrosis (asbestosis)
Bronchial carcinoma
Mesothelioma
