Smoking-Related Lung Disease

Question 1

Smoking related lung disease

Answer 1

• Obstructive lung disease
• Interstitial lung disease
  
  • RB
  • RB-ILD
  • DIP
  • LCH
  • Fibrosis (NSIP)
• Acute eosinophilic pneumonia

Question 2

Small airways

Answer 2

• < 2mm

Question 3

RB Findings

Answer 3

• GG centrilobular nodules
  
  • ill-defined
  • upper lobe predominance
• GGO
• bronchial wall thickening
• decreased attenuation
• emphysema
• air trapping
• reticulation

Question 4

How to differentiate RB or RB-ILD

Answer 4

Have to be based on clinical history and symptoms

dyspnea

radiology and pathology are the same

Question 5

DIP

Answer 5

• extension of RB and RB-ILD
• young heavy smokers
• smokers’ macrophages are already in the distal alveoli, outside of distal small airways
• now more lower lobe predominance
• findings
  
  • GGO - basal predominance
  • reticulation
  • cysts!

Question 6

Langerhans Cell Histiocytosis

LCH

Answer 6

• EXCLUSIVELY cigarette smokers!
• male predominance
• may be asymptomatic, but dyspnea cough
• findings - upper lobe predominance!
  
  • nodules
  • nodules and cysts (distal dilated airways, bizarre in shape)
  • nodules, cysts, and emphysema

Question 7

Definition of emphysema

Answer 7

Permanent enlargement of airspaces distal to the terminal bronchiole

distruction of the walls

without obvious fibrosis

Question 8

Location of “Holes” in lung

Answer 8

emphysema - holes with no walls, upper lobes

fibrosis - holes with walls, lower lobes