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23 Cards in this Set
- Front
- Back
Sarcoidosis definition
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- Idiopathic multi-system non-necrotizing granulomatous inflammation
- a granuloma is focal accumulation of epithelioid histiocytes |
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Sarcoidosis Clinical
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- Multi-system granulomatous disease
– Adults, B>W, F>M – complain of dyspnea - a diagnosis of exclusion – must exlude infection |
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Sarcoidosis radiology
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- Interstitial infiltrates in bronchovascular distribution
– Usually hilar adenopathy – usually diagnosed w/ transbronchial biopsy |
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Sarcoidosis path
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- Tight, well-formed non-caseating granulomata
– Focal accumulations of epithelioid histiocytes – can fuse together to make Langhan’s giant which are multinuclear |
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Hypersensitivity pneumonitis definition
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Specific immune response to inhaled organic dusts
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Hypersensitivity pneumonitis clinical
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- Organic dusts from occupational or environmental exposure
– can be acute and chronic – come in w/ dyspnea, cough, fatigue |
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Hypersensitivity pneumonitis organic dusts
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- Organic antigens are microorganisms in hay, sugarcane, and maple bark
– can also be in hot tubs and air conditioners – animal proteins in birds, pets, and grain weevils – also synthetic organic chemicals |
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Hypersensitivity pneumonitis radiology
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bilateral interstitial linear or nodular pattern
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Hypersensitivity pneumonitis path
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- Patchy peri-bronchiolar expansion and interstitial expansion from chronic inflammation
- loosely formed granulomata – the expansion will usually be stellate |
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Pneumoconiosis definition
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Inorganic dust accumulation +/- fibrosis
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Pneumoconiosis clinical
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- an occupational or environmental exposure and the radiology varies by dust
– can present as restrictive or obstructive due to loss of elasticity, but usually its restrictive – Sx are SOB |
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Pneumoconiosis fibrogenic is from silica (SiO2)
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- crystalline, 1-2 mm diameter
– early is just an accumulation of histeocytes (so you need hx!), but late will show Fibrotic Nodules |
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Pneumoconiosis fibrogenic is from asbestos (SiO4)
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- has an Fe/protein coat (ferruginous bodies)
– will see Patchy Sub-Pleural Fibrosis from collagen |
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Pneumoconiosis fibrogenic from coal
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- if silica-free, you will only see accumulation of coal
– will only trigger fibrosis if it has silicates in it – w/ coal, its black no matter what the stain – can get this from cigarette smoke, so get the hx |
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causes of sub-plerual fibrosis
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– asbestosis (more likely than mesolthelioma)
- UIP - rheumatoid lung disease |
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Usual interstitial pneumonia (UIP) definition
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- Progressive patchy interstitial fibrosis
- aka Idiopathic pulmonary fibrosis (IPF) |
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Usual interstitial pneumonia (UIP) clinical
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– in adults (mean 51) – poor response to steroids w/ a 66% mortality – dx early so you can transplant
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Usual interstitial pneumonia (UIP) radiology
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- Patchy subpleural infiltrates from fibrosis, DDx asbestos, rheum
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Usual interstitial pneumonia (UIP) path
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- will show patchy interstitial inflame and fibrosis that is alternating with normal parenchyma (temporally heterogeneous)
– Morphological overlap with rheum dzs like scleroderma – looks like honeycomb |
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proliferating phase of DAD definition
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Interstitial fibroblastic proliferation >1 week after acute lung injury
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proliferating phase of DAD clinical
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- decreased pulm compliance -> mechanical ventilation
– 50% mortality – the ones that survive can remodel the lung or scar it off – we don’t know what lets some do this and some die |
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proliferating phase of DAD radiology
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- will show diffuse, interstitial > alveolar pattern
– also increased interstitial markings |
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proliferating phase of DAD path
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- will show Interstitial + intra-alveolar fibroblastic proliferation
– Temporally uniform – there is lots of lot of fibroblastic response and DAD is defined by this proliferation (the organizing phase) |