Pathology of interstitial lung disease Flashcards
what is the hallmark of chronic interstitial disease?
reduced compliance (stiff lungs) leading to dyspnea and hypoxia
honeycomb lung is the end stage of what condition?
lung disease
what is the end stage of lung disease?
honeycomb lung
ARDS corresponds to a severe form of what condition?
acute lung injury
what is the first event in acute lung injury?
endothelial damage
what is the general cause of ARDS? what is a specific condition that can cause it?
diffuse alveolar capillary damage (endothelial damage then epithelial damage)
DAD (diffuse alveolar damage)
what is the most common cause of non-cardiogenic pulmonary edema?
ARDS
what are the most common direct injuries related to ARDS?
infectious agents (pneumonia) aspiration
what are the most common indirect injuries related to ARDS?
shock
sepsis
what are the characteristics of ARDS? (CXR, wedge pressure)
CXR - bilateral infiltrates
wedge pressure - less than 18 mm Hg
what are the paO2s for ALI and ARDS?
ALI - less than 300
ARDS - less than 200
what is the pathogenesis of ARDS?
imbalance between proinflammatory and anti-inflammatory mediators
increased vascular permeability
loss of diffusion capacity
widespread surfactant abnormalities
IL-8 is a potent chemoattractant for what cell type?
neutrophils
what chemoattractant attracts neutrophils?
IL-8
what is the gross morphology of the lungs in ARDS?
heavy, firm, red, stiff
what is the micro morphology of the lungs in ARDS?
alveolar hyaline membranes
proliferation of type II pneumocytes
TRALI is due to what type of antibodies?
anti-HLA or anti-HNA
diffuse interstitial disease initially starts out as what disease?
alveolitis
what is the final stage of diffuse interstitial disease?
end stage fibrotic lung (honeycomb lung)
what is the histological pattern of UIP?
fibrosis
what cell type plays a key role in inflammation seen in diffuse interstitial disease?
macrophage
is UIP specific for IPF?
no
what is the pathogenesis of IPF? what cell types / molecules are involved?
repeated cycles of epithelial activation / injury by some unidentified agent - abnormal wound healing
Th2 T cells, TGFB-1
what molecules blocks the action of caveolin in fibroblasts? what is the result?
TGFB-1
overabundance of fibrosis
what is the microscopic appearance of IPF?
temporal heterogeneity - early and late lesions
what is the hallmark appearance of UIP?
patchy interstitial fibrosis, varying in intensity and age
which lung diseases require transplant?
UIP (IPF)
definition: pneumoconioses
non-neoplastic lung reaction to inhalation of any aerosol (including air pollution)
what is the key factor in pneumoconioses pathogenesis?
capacity of inhaled dusts to stimulate fibrosis
