Pathoma Pneumoconioses 12/07

Question 1

Silicosis. What specialities?

Answer 1

Silica miners;
sandblasting;
foundaries (liejykla)

Question 2

sandblasting;
foundaries (liejykla)

What pneumoconiose?

Answer 2

silicosis

Question 3

when manifest silicosis?

Answer 3

initially asymptomatic, symptoms 10-20 years post exposure

Question 4

Silicosis pathologic findings?

Answer 4

Birefringent silicate particles;

fibrotic silicotic nodules - in the center collagen, surrounded with fibroblasts and DUST-LADEN MACROPHAGES

Nodules are in the upper lobes of the lung

Question 5

DUST-LADEN MACROPHAGES?

Answer 5

silicosis

Question 6

fibrotic/collagenous nodules?

Answer 6

silicosis

Question 7

silicosis increase risk of what?

Answer 7

tuberculosis - because impair phagolysosome formation by macrophages

Question 8

Asbestosis. what specialities?

Answer 8

shipyard; textile; construction workers, plumbers/pipe work; insulation manufacturing and application; drywall workers

Question 9

shipyard; textile; construction workers, plumbers/pipe work; insulation manufacturing and application; drywall workers

What pneumoconiose?

Answer 9

Asbestosis

Question 10

Hallmark of asbestosis?

Answer 10

pleural PLAQUES

Question 11

Asbestosis. Pathohisto?

Answer 11

1. progressive fibrosis of lungs
2. pleural plaques

Question 12

Asbestosis. what tumors?

Answer 12

bronchogenic carcinoma (from bronchial epithelium) - most common

mezothelioma - second most common. For this highest risk factor ir asbestosis

Question 13

Asbestosis. How look asbestos bodies?

Answer 13

long, golden-brown fibers with associated iron

Question 14

asbestosis. sequence of events?

Answer 14

asbestos fibers -> epithelial cell injury -> activation of macrophages -> chronic interstitial inflammation -> fibrosis.

Question 15

Mezothelioma. WHAT POSITIVE IMUNOHISTOCHEMISTRY?

Answer 15

Cytokeratin and calretinin

Question 16

Mezothelioma - pathohisto?

Answer 16

• cuboidal/flattened cells (epithelium like) OR spindle cells (stromal like).
• Cytokeratin and calretinin POSITIVE
• Electron microscopy: polygonal tumor cells with numerous long, slender microvili and ABUNDANT TONOFILAMENTS.

Question 17

ABUNDANT TONOFILAMENTS. What tumor?

Answer 17

mezothelioma

Question 18

How to differentiate between asbestos and other ferruginous bodies?

Answer 18

abestos body is TRANSLUCENT

Question 19

coal workers pneumoconiosis. what population?

Answer 19

coal miners

Question 20

Coal workers pneumoconiosis. how looks like lungs?

Answer 20

MASSIVE EXPOSURE –> DIFFUSE FIBROSIS (black lung)

Question 21

Coal workers pneumoconiosis. associated with what?

Answer 21

rheumatoid arthritis (Caplan syndrome)

Question 22

Coal workers pneumoconiosis. Mild exposure to carbon (eg polution) lead to what?

Answer 22

it results in ANTHRACOSIS (collection of carbon-laden macrophages). Not clinicaly significant

Question 23

Coal workers pneumoconiosis. what happens with large and fine particles?

Answer 23

Larger particles become trapped by mucus secretions in the trachea, bronchi, and proximal bronchioles; these trapped particles are swept upward toward the pharynx by the collective beating of ciliated cells.

The finest particles (<2 µm) can travel past the highly ciliated airways into the respiratory bronchioles and alveoli, where they are phagocytized by alveolar macrophages.

Question 24

Coal workers pneumoconiosis. what happens when macrophages engulf particles?

Answer 24

release of a number of cytokines that induce pulmonary inflammation. Growth factors, including platelet-derived growth factor and insulin-like growth factor, are also released and stimulate fibroblasts to proliferate and produce collagen. This production results in progressive interstitial lung fibrosis that characterizes the pneumoconioses.

Question 25

rheumatoid arthritis (Caplan syndrome) WHAT PNEUMOCONIOSE?

Answer 25

Coal worker’s

Question 26

Beryllium. What specialities?

Answer 26

Beryllium miners and aerospace industry workers

Question 27

aerospace industry workers?

Answer 27

Beryllium.

Question 28

Beryllium. Histopathology?

Answer 28

NONCASEATING granulomas in the hillar lymph nodes and SYSTEMIC ORGANS

Question 29

NONCASEATING granulomas in the hillar lymph nodes and SYSTEMIC ORGANS

Answer 29

Beryllium

Question 30

Beryllium. Increase risk for what?

Answer 30

lung cancer