Restrictive (Interstitial) Lung Diseases Flashcards
What are some structures you can expect to see in histopathology slide of sarcoidosis?
- Schaumann bodies: laminated concretions of calcium and protein
- Asteroid bodies: stellate inclusion in giant cells
THESE ARE NOT PATHOGNOMONIC
like IPF, sarcoidosis is a diagnosed by ______
exclusion
what are 4 features of restrictive lung diseases?
- fibrosis
- dyspnea
- V/Q mismatch
- progression to respiratory failure with pulmonary HTN and cor pulmonale
uniform fibrosing process giving a chicken wire appearance is seen with _____
NSIP (non specific interstitial pneumonia)
hypersensitivity pneumonia aka extrinsic allergic alveoli’s is often associated with _____
occupational exposures where patients inhale organic antigens;
ex. farmer’s lung, silo filler’s disease, byssinosis (textile workers with “Monday morning blues”)
_____ presents with diffuse alveolar damage and hyaline membrane similar to those found in ARDS
acute interstitial pneumonia
what are the 4 major categories of restrictive lung diseases
- Fibrosing: UIP, NSIP, COP (cryptogenic organizing pneumonia), CVD (collagen vascular disease), pneunoconiosis
- Granulomatous: sarcoid, HP (hypersensitivity pneumonia)
- Eosinophilic: (Loeffler, Drug/allergy, chronic eosinophilic pneumonia)
- Smoking related: DIP (desquamative interstitial pneumonia), RB ILD (respiratory bronchiolitis interstitial lung disease )
organizing pneumonia can be seen following: (3)
- infectious pneumonia
- transplantation (lung and bone marrow)
- collagen vascular diseases
occupational exposures of inhaled antigens is associated with what type of lung disease?
restrictive (hypersensitivity pneumonia)
↓ diffusion capacity
↓ lung compliance
↓ total lung volume (TLC)
how can you tell the difference between UIP/IPF and non specific interstitial pneumonia ?
there is NO HONEYCOMB appearance with non specific interstitial pneumonia
sarcoidosis is thought to be due to a type ____ HS reaction to an unidentified antigen
type 4 (driven by CD4 helper T cell)
non caseating granulomas in sarcoidosis can be found in what layer?
subepithelial
the main feature of restrictive lung diseases is _____
FIBROSIS; the decreased lung compliance will cause ↑ work to breathe and cause dyspnea
in what cigarette smoking associated lung diseases does the macrophages accumulate within the lumen of the respiratory bronchioles?
respiratory bronchiolitis
there is an ↑ or ↓ ratio of CD4:CD8 T cell count;
↑ (almost 10:1) and these CD4 T cells accumulate in the lungs
hypersensitivity pneumonia (extrinsic allergic alveolitis) is a type _____ HS reaction
type 3 but in chronic exposure can get granuloma formation and get type 4 HS
what is a unique feature on histology of crytogenic organizing pneumonia
- alveolar architecture is NOT destroyed
what is the first step of restrictive lung disease
“alveolitis: damage to pneumocytes and endothelial cells
what would you expect to see on CXR of someone with sarcoidosis?
- bilateral hilar lymphadenopathy with or w/o parenchymal infiltrates
organizing pneumonia can be seen on the histopathology slide of someone with ______
hypersensitivity pneumonia;
poorly formed NON necrotizing granulomas with giant cells
cobblestoned pleural surface with honeycomb cysts is a description of what pulmonary disease?
IPF / UIP
idiopathic pulmonary fibrosis / usual interstitial fibrosis
because sarcoidosis is a systemic disease, other than the lungs, what are some other organs that can be affected?
- skin: erythema nodosum
- eyes/lacrimal glands: sicca syndrome (sjogren syndrome where you have dry eyes and mouth)
- parotid glands: bilateral partotidis
- spleen
- liver
- bone marrow
what are Masson bodies and what lung pathology would you expect to see them?
Masson bodies are polypoid plugs of loose fibroblastic tissue filling the alveolar spaces
seen in cryptogenic organizing pneumonia (bronchiolitis obliterans organizing pneumonia)
respiratory bronchiolitis is associated with _______ fibrosis
peribronchiolar
