SFP: Pneumoconiosis Flashcards
What is pneumoconiosis?
A disease of the lung due to inhalation of dusts that is characterized by inflammation, coughing, and fibrosis.
What are the agents associated with pneumoconiosis?
Coal dust, silica, and asbestos.
What is the pattern of development for pneumoconiosis?
Dyspnea that progresses 10-20 years after longstanding exposure.
What is the clinical presentation of pneumoconiosis?
Dyspnea after 10-20 years, pulmonary HTN, cor pulmonale (right sided HF), clubbing from hypoxia.
Describe how mineral dusts of different sizes are pathogenic.
- > 5 micrometers: impact the mucociliary elevator in the upper respiratory tract. 2. <0.5 micrometers act like a gas and don’t get lodged. 3. 1-5 micrometers impact distal airways.
What cell initiates the process associated with pneumoconiosis damage?
Macrophages; they ingest the dust particles and lead to recruitment of fibrotic, toxic, and inflammatory factors.
What part of the lung does coal dust impact?
Upper lobes or upper zones of lower lobes.
What part of the lung does silica impact?
Upper lobes or upper zones of lower lobes.
Smoking enhances the effect of which mineral dusts?
All of them, but more so with asbestos.
Which of the mineral dusts is the least pathogenic?
Coal dust.
What is anthracosis?
Carbon in macrophages in alveolar spaces and interstitum; this is nonfibrogenic.
Describe simple coal workers pneumoconiosis.
It has not progressed to progressive massive fibrosis; it may be picked up incidentally. Anthracosis will be seen, but usually not a lot of fibrosis.
Describe complicated coal workers pneumoconiosis.
There is progressive massive fibrosis as well as anthracosis and possibly some honeycombing.
Which pneumoconiosis increases TB risk?
Silica; it depresses cell mediated immunity, putting patients at higher risk of developing TB.
What is the most preventable chronic occupational disease?
Silicosis.
Describe silicosis.
Very prevalent chronic occupational disease associated with sandblasters, hard rock mining, or stone cutting. Also associated with quartz.
What is a classic pathologic finding in silicosis?
Nodular fibrosis.
What is the clinical presentation of chronic silicosis?
SOB later on, pulmonary HTN, cor pulmonale.
How do we differentiate chronic silicosis from granulomas?
Granulomas have giant cells and epithelioid macrophages, while silicosis lesions have collagen and fibroblasts.
Describe the morphology of asbestosis.
Diffuse interstitial fibrosis, pleural thickening, lower lobe predominance.
What are the two asbestos fibers? Which is more pathogenic?
Serpentine and amphibole; amphibole is more pathogenic.
What is a likely exposure in someone with mesothelioma?
Asbestos; NOT cigarette smoking.
What is mesothelioma?
Malignant tumor of pleura and peritoneum.
Which of the mineral dusts increase the risk of cancer?
Asbestos.
What part of the lung does asbestos impact?
Lower lobes.
What are asbestos bodies?
Macrophages that engulf asbestos fibers; Golden-brown, fusiform, or beaded rods with a translucent center.
What is the most common manifestation of someone exposed to asbestos (non-cancer)?
Fibrous plaques.
What are possible manifestations of someone exposed to asbestos?
Fibrous plaques, bronchogenic carcinoma, pleural effusion, interstitial pulmonary fibrosis.
Briefly describe fibrous plaques in asbestos exposure.
They’re found in the parietal pleura and are dense with no asbestos bodies. They are benign.
