Path, Lung, Chronic Interstitial Diseases, Fibrosing Diseases

Front 1

what is the distribution of fibrosis radiologically in usual interstitial pneumnonia?

Back 1

subpleural regions and interlobular septa

Front 2

what are the characteristic microscopic features of usual interstitial pneumonia?

Back 2

honeycombing

temporal heterogeneity of fibrosing lesions

fibroblastic foci in new lesions

vessels with pulmonary arterial hypertensive changes

Front 3

what pattern can acute exacerbations of usual interstitial pneumonia show?

Back 3

DAD (diffuse alveolar damage)

Front 4

what are the two major patterns in nonspecific interstitial pneumonia?

Back 4

cellular or fibrosing

Front 5

what is the prognosis/age in the two major patterns in nonspecific interstitial pneumonia?

Back 5

cellular pattern in younger patients and with better prognosis compared to fibrosing pattern of NSIP and UIP

Front 6

what are the characteristic microscopic features in nonspecific interstitial pneumonia?

Back 6

cellular pattern with interstitial inflammation composed of lymphocytes and few plasma cells

fibrosing pattern with patchy or diffuse interstitial fibrosis without temporal heterogeneity or fibroblastic foci

Front 7

what are the radiologic features of (cryptogenic) organizing pneumonia?

Back 7

airspace consolidation in subpleural or peribronchial regions

Front 8

what are the characteristic microscopic features in cryptogenic organizing pneumonia?

Back 8

intraalveolar and often intrabronchioloar fibrosis with formation of Masson bodies, ie loose organizing connective tissue

underlying lung architecture is normal!

no interstitial fibrosis or honeycombing

Front 9

what are the characteristic microscopic features in anthracosis of the lung?

Back 9

carbon laden macrophages along the lymphatics (also pleura) or in organized lymphoid tissue along the bronchi or in the lung hilus

Front 10

what are the forms rising in severity in coal worker's pneumoconiosis?

Back 10

anthracosis in smokers, urban dwellers, coal workers

simple CWP with macules (smaller) or nodules (larger)

complicated CWP with progressive massive fibrosis

Front 11

what are the characteristic microscopic features in simple CWP?

Back 11

coal macules or nodules containing carbon-laden macrophages

Front 12

what areas of the lung are heavily involved in simple CWP?

Back 12

upper lobes and upper zones of the lower lobew

Front 13

what are the characteristic macrocscopic features in complicated CWP?

Back 13

intensely blackened scars larger than two centimetres

Front 14

what are the characteristic microcscopic features in complicated CWP?

Back 14

dense collagen with pigment

center of lesion often necrotic

Front 15

what are the implications of coal worker's pneumoconiosis concerning tuberculosis and lung cancer?

Back 15

no increased risk

Front 16

what are the two major forms of silicosis?

Back 16

crystalline and amorphous

crystalline form much more fibrogenic

Front 17

what are the characteristic microcscopic features in silicosis?

Back 17

nodular lesions with concentric layers of hyalinized collagen surrounded by a dense capsule of more condensed collagen

birefringent silica particles under polarized light

Front 18

what are the characteristic macrocscopic features in silicosis?

Back 18

discrete pale to blackened nodules to scars in more severe cases

sometimes with cavitation, due to ischemia or superimposed tuberculosis

Front 19

what are radiographic features of both silicosis and CWP?

Back 19

eggshell calcification of hilar lymph nodes

Front 20

what are the implications of silicosis concerning tuberculosis and lung cancer?

Back 20

increased susceptibility to tuberculosis

increased risk for lung cancer in crystalline form (controversial)

Front 21

what disorders are linked to asbestos exposure?

Back 21

pleura with localized fibrous plaques and pleural effusions

parenchyma with interstitial fibrosis as seen in diffuse interstitial fibrosis but with presence of asbestos bodies

tumors are lung carcinomas, mesotheliomas, laryngeal carcinomas, maybe colon carcinoma

Front 22

what are the two geometric forms of asbestos

Back 22

serpentine and amphibole

serpentine group with chrysotile (white asbestos), amphibole group with various minerales

amphiboles more pathogenic

Front 23

what are the characteristic microcscopic features in asbestosis?

Back 23

pattern of fibrosis similar to that seen in usual interstitial fibrosis but with presence of asbestos bodies, which are iron-protein complexes

Front 24

what is the (initial) distribution of fibrosis in asbestosis?

Back 24

lower lobes and subpleurally, in contrast to silicosis and CWP

Front 25

what is the distribution of fibros plaques in asbestosis?

Back 25

anterior and posterolateral aspects of the parietal pleura and over the domes of the diaphragm

Front 26

do fibrous pleural plaques in asbestosis contain asbestos bodies?

Back 26

NO!

Front 27

what are drugs commonly associated with drug-induced lung diseases?

Back 27

bleomycin

methotrexate

amiodarone

nitrofurantoin

Front 28

what are the drugs causing hypersensitivity pneumonitis?

Back 28

nitrofurantoin and methotrexate

Front 29

what are the drugs causing pneumonitis and fibrosis?

Back 29

bleomycin and amiodarone

Front 30

what is the time frame in occurence of acute radiation pneumonitis?

Back 30

one to six months after fractionated radiation

Front 31

what is the histologic pattern of chronic radiation pneumonitis?

Back 31

diffuse alveolar damage with atypia of hyperplastic type II cells and characteristically foam cells within vessel walls

Front 32

what are smoking-related interstitial diseases?

Back 32

desquamative interstitial pneumonia

respiratory bronchiolitis-associated interstitial lung disease

Front 33

what are characteristic microscopic features of desquamative interstitial pneumonia?

Back 33

accumulation of large numbers of smoker's macrophages in alveoli

alveolar septa thickened by sparse inflammatory infiltrate of lymphocytes, plasma cells and occasional eosinophils